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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153808806
Report Date: 09/27/2022
Date Signed: 09/27/2022 02:17:29 PM


Document Has Been Signed on 09/27/2022 02:17 PM - 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, 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:152CENSUS: 71DATE:
09/27/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Rosalva BanuelosTIME COMPLETED:
02:30 PM
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On September 27, 2022 Licensing Program Analyst (LPA) Kari McWilliams conducted an unannounced Plan of Correction to clear deficiency's cited during the annual inspection on August 25, 2022. LPA McWilliams met with Site Supervisor Rosalva Banuelos and toured the facility inside and out and took a census.

LPA McWilliams went through all staff records that were currently working and verified all required forms were present and up to date in each personnel file.

LPA cleared previously cited deficiencies on this date and provided licensee with a "Letter of Deficiency Citations Cleared." This letter must be filed in the facility for three years and upon request made accessible to the public for review.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted and report was reviewed with the facility representative Rosalva Banuelos.



A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2022
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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