<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103910595
Report Date: 05/13/2022
Date Signed: 05/13/2022 10:25:55 AM


Document Has Been Signed on 05/13/2022 10:25 AM - 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:AGUILAR, BIANCA FAMILY CHILD CAREFACILITY NUMBER:
103910595
ADMINISTRATOR:AGUILAR, BIANCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 231-5307
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY:14CENSUS: 6DATE:
05/13/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Blanca AguilarTIME COMPLETED:
11:00 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 5/13/22 an unannounced case management visit was conducted today by LPA's Caroline Harris and Stephanie Vega-Gonzalez. Met with licensee, Blanca Aguilar. A census was taken. The purpose of this report to to address possible citations that were observed during the inspection. Upon review of staff files, some forms were missing. LPA, Harris gave the licensee a list of requirements that are to be in each staff file.

An exit interview was conducted and a copy of this report was provided to the licensee, Blanca Aguilar and was reviewed. This report shall be made available to the public upon request. The LIC 9213 Notice of Site Visit form was provided to the licensee and must remain posted for 30 days.
SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
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)
Page: 1 of 1