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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153902470
Report Date: 05/03/2023
Date Signed: 05/03/2023 10:32:08 AM


Document Has Been Signed on 05/03/2023 10:32 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, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:CADAOAS, ELISEA FAMILY CHILD CAREFACILITY NUMBER:
153902470
ADMINISTRATOR:CADAOAS, ELISEAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 725-4317
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY:14CENSUS: 0DATE:
05/03/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Elisea CadaoasTIME COMPLETED:
10:45 AM
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On 05/03/2023, Licensing Program Analyst (LPA), Jose Penate conducted an unannounced Case Management inspection today with Licensee, Elisea Cadaoas. Licensee stated she has not been watching day-care children. Licensee stated she is wanting to place her license on Inactive Status for 6 months from todays date. During today's inspection, licensee filled out inactive form LIC 9211. Licensee has been instructed to follow the conditions listed on the inactive form.

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

Exit interview conducted with the licensee, Elisea Cadaoas.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2023
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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