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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808459
Report Date: 10/18/2024
Date Signed: 10/18/2024 09:57:53 AM


Document Has Been Signed on 10/18/2024 09:57 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
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:OUR LADY OF PERPETUAL HELP PRESCHOOLFACILITY NUMBER:
153808459
ADMINISTRATOR:AMARANTE, THERESAFACILITY TYPE:
850
ADDRESS:124 COLUMBUS STREETTELEPHONE:
(661) 327-7741
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93305
CAPACITY:40CENSUS: 24DATE:
10/18/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Theresa AmaranteTIME COMPLETED:
10:30 AM
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On 10/18/2024, Licensing Program Analyst (LPA) Behatriz Gonzalez conducted an unannounced plan of correction (POC) inspection. LPA Gonzalez met with Director, Theresa Amarante and informed her the purpose of the inspection. A tour inside and out of the facility was conducted and a census was taken.


On 09/17/24, LPA Gonzalez conducted an unannounced annual inspection and observed through file reviews that the facility did not have complete staff files. LPA Gonzalez conducted an plan of correction for the staff files to be completed on October 15, 2024 and observed that staff files were now complete, or had a Doctors appointment in place to complete the missing 503 form. LPA Gonzalez returned on todays date to review documentation for staff files and confirmed that all forms needed are completed with all information required, or a pending doctors appointment. .


Exit interview conducted and report was reviewed with Director, Theresa Amarante. Appeal rights were provided.

Per Title 22, Division 12, of the California Code of Regulations, no deficiencies are cited.

This report shall be made available to the public upon request.

LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISOR'S NAME: Scott HerringTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Behatriz GonzalezTELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2024
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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