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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153909532
Report Date: 02/27/2023
Date Signed: 02/27/2023 04:21:42 PM


Document Has Been Signed on 02/27/2023 04:21 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:PANTOJA, SONIA FAMILY CHILD CAREFACILITY NUMBER:
153909532
ADMINISTRATOR:PANTOJA, SONIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 487-4124
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY:14CENSUS: 5DATE:
02/27/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Sonia Pantoja- Licensee TIME COMPLETED:
04:35 PM
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On 2/27/23, an unannounced Case Management - Plan of Correction (POC) Inspection was conducted by Licensing Program Analyst (LPA) Jessika Thompson. LPA met with Licensee Sonia Pantoja to review POC requirements associated to deficiencies cited on 1/17/23. Today, LPA verified the following:
  • Licensee maintains Emergency Medical Information for children in care
  • Licensee maintains Liability Insurance Affidavits on file for children in care
  • Licensee maintains proof of immunization on file for children in care
  • Licensee completed Child Abuse Mandated Reporter training on 1/19/2023
  • Licensee maintains proof of Notification of Parents Rights forms on file for children in care
  • Licensee maintains proof of sleep log completion on file for infants in care

LPA cleared 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 reviewed.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited today. Licensee was provided a copy of appeal rights.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
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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