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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103900418
Report Date: 05/15/2019
Date Signed: 05/15/2019 09:54:32 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:LOPEZ,CYNTHIAFACILITY NUMBER:
103900418
ADMINISTRATOR:LOPEZ,CYNTHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 369-4859
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:14CENSUS: 6DATE:
05/15/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Cynthia LopezTIME COMPLETED:
10:15 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Robert Gutierrez & Theresa Marquez conducted an unannounced case management - other inspection. LPAs met with Licensee Cynthia Lopez. The purpose of todays inspection was to inspect the newly installed pool fence. Currently there are no windows or doors that have direct access to the swimming pool. Two pool gate entrances swing away from the pool. The pool gates are self latching and self closing. The latch that closes the pool gate is higher than 54 inches. There is one wrought iron panel located directly in front of the licensees master bedroom that has a gap bigger than four inches. Licensee was informed per Title 22 regulations there should be no gap bigger than four inches. Due to the gap being bigger than four inches the licensee stated she shall add two inches of cement to close the gap. Licensee must correct this issue in order to prevent a civil penalty.

During todays inspection LPA Marquez cleared deficiencies cited on 04/10/2019. The only item left to be completed is the pool fence.

Licensee has until 05/17/2019 to correct the pool fence.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert GutierrezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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