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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103900495
Report Date: 02/25/2020
Date Signed: 02/25/2020 10:29:21 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:CASTRO,CATALINAFACILITY NUMBER:
103900495
ADMINISTRATOR:CASTRO,CATALINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 493-0271
CITY:COALINGASTATE: CAZIP CODE:
93210
CAPACITY:14CENSUS: 0DATE:
02/25/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Catalina CastroTIME COMPLETED:
10:45 AM
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On 02/25/2020 an unannounced Case Management inspection was conducted today by Licensing Program Analyst (LPA) Robert Gutierrez. The initial purpose of todays visit was to conduct an annual random inspection. However, licensee Catalina Castro indicated she has not cared for children since having a recent medical operation. During todays inspection Licensee signed the request for inactive status. Licensee completed the form and shall be on inactive status until 08/31/2020 or until the she calls the Fresno Regional office stating she wants to open her day care.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert GutierrezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020
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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