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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153908102
Report Date: 08/11/2022
Date Signed: 08/11/2022 10:35:19 AM

Document Has Been Signed on 08/11/2022 10:35 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:JONES, DEBRA FAMILY CHILD CAREFACILITY NUMBER:
153908102
ADMINISTRATOR:JONES, DEBRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 805-1205
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/11/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Debra JonesTIME COMPLETED:
10:45 AM
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On 08/11/2022, Licensing Program Analysts (LPA), Jose Penate conducted an unannounced Case Management inspection today with Licensee, Debra Jones. Licensee stated she has not been watching day-care children since July 7, 2022. Licensee stated she is wanting to place her license on Inactive Status today. Licensee request to go on Inactive status for 1 year from today's 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, Debra Jones. A copy of this report shall be placed in facility file for public review.

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

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

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Jose Penate
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022
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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