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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103904987
Report Date: 02/07/2020
Date Signed: 02/08/2020 07:32:58 PM

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:PEREZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
103904987
ADMINISTRATOR:PEREZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 646-9005
CITY:PARLIERSTATE: CAZIP CODE:
93648
CAPACITY:14CENSUS: 3DATE:
02/07/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Maria PerezTIME COMPLETED:
12:00 PM
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An unannounced Plan of Correction inspection was conducted by Licensing Program Analyst (LPA) Diana Martinez with licensee Maria Perez. Also present was assistant/spouse Othoniel Perez and three day care children. LPA toured the facility inside and outside and census taken. The purpose of this inspection is to clear a deficiency cited during the annual inspection conducted on 1/21/20. On 1/21/20, ants were observed on kitchen counter.

During this inspection licensee indicated that a home insecticide was used to successfully treat ant problem. LPA visually confirmed that counters, cupboards, and drawers, are clean and free of pests. Deficiency cited on 1/21/20 is now cleared.

Assistant/spouse is scheduled for Spanish CPR/First Aid training on 3/7/20, and licensee will submit a copy of assistant’s CPR/First Aid certification.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies cited during today's inspection.

Exit interview was conducted with licensee Maria Perez. A Notice of Site Visit Form was posted to parent’s board and must be posted for 30 days. This report shall be available for public review upon request.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D MartinezTELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
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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