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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103900799
Report Date: 05/13/2022
Date Signed: 05/13/2022 02:58:36 PM


Document Has Been Signed on 05/13/2022 02:58 PM - It Cannot Be Edited

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:PRECIADO, EMILYFACILITY NUMBER:
103900799
ADMINISTRATOR:PRECIADO, EMILYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 251-1727
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:14CENSUS: DATE:
05/13/2022
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Emily PreciadoTIME COMPLETED:
03:00 PM
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On 05/13/2022 Licensing Program Analysts (LPAs) Rene Mancinas and Diane Mercado, conducted an unannounced case management inspection. LPAs met with Licensee, Emily Preciado. The purpose of inspection was to provide Licensee with a notification letter of immediate exclusion for adult son, Eric Preciado, which informs Licensee that Eric Preciado is excluded from being present in all facilities licensed by the Department. Licensee is to ensure Eric Preciado be immediately excluded from having contact with day care children or being physically present at (any) facility. Licensee was advised exclusion order remains in place, unless otherwise notified in writing by the Department. Licensee was provided with information/rights to appeal Department’s order within 15 days of today’s service notification. Licensee signed a copy of order acknowledging receipt. Licensee was provided with original copy of order.

In addition, LPAs provided Licensee with copies of LIC 995B ‘Family Child Care Home Addendum To Notification of Parent’s Rights (Regarding Removal/Exclusion). Licensee was informed she is to provide LIC 995B form to parents by the end of day, or by the next time day child(ren) are in care. Licensee understands parents are to sign LIC 995B acknowledging receipt of notification, and the form must be stored in child(ren) file, and subject to review/verification by the Department during future inspections.

Per California Code of Regulations Title 22 Division 12 Chapter 3, no deficiency is being cited today. Notice of Site to be posted for 30 days.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:
DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/13/2022
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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