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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808806
Report Date: 10/17/2019
Date Signed: 10/17/2019 01:52:04 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:EDISON PRESCHOOLFACILITY NUMBER:
153808806
ADMINISTRATOR:ANDREWS, ERICAFACILITY TYPE:
850
ADDRESS:1036 VINELAND ROADTELEPHONE:
(661) 363-5394
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:113CENSUS: 113DATE:
10/17/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Rosalva BanuelosTIME COMPLETED:
02:15 PM
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An unannounced case management inspection is made today by Licensing Program Analyst (LPA) Gloria Reyes. LPA met with Site Supervisor, Rosalva Banuelos. LPA toured the facility inside and outside.

The purposes of today's visit is to ensure that shelves have been braced and secured in the preschool classrooms. LPA verified that all shelves have been secured.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency was cited during today's visit.

An exit interview conducted with Site Supervisor, Rosalva Banuelos. A copy of this report was provided and discussed. A Notice of Site Visit Form was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
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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