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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103910330
Report Date: 12/10/2019
Date Signed: 12/11/2019 11:47:21 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:MAREZ, LINDA FAMILY CHILD CAREFACILITY NUMBER:
103910330
ADMINISTRATOR:MAREZ, LINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 639-8472
CITY:PARLIERSTATE: CAZIP CODE:
93648
CAPACITY:14CENSUS: 8DATE:
12/10/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Linda Marez TIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Diana Martinez conducted an unannounced case management inspection to follow up on an unusual incident that occurred at the facility on 11/13/19. The incident was called in on 11/14/19, and was followed by an Unusual Incident Report (LIC 624B). LPA met with licensee Linda Marez and also present were assistants Chloe Caballero and Elisha Herrera.

The incident occurred when law enforcement contacted licensee on 11/13/19, regarding a child that attended the facility for a short period. Children’s roster and other documents were obtained from licensee.

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

Exit interview conducted with licensee Linda Marez and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D MartinezTELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019
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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