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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910261
Report Date: 05/01/2019
Date Signed: 05/01/2019 10:15:41 AM

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:REYES, LILIANA FAMILY CHILD CAREFACILITY NUMBER:
153910261
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
05/01/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Liliana ReyesTIME COMPLETED:
10:30 AM
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An unannounced Case Management inspection is conducted this date by Licensing Program Analysts (LPAs) Gloria Reyes and Angelica Slaughter. LPAs met with Licensee, Liliana Reyes. A tour of home is conducted inside and outside.

The purpose of today's visit is to inspect the backyard which was previously off-limits. LPAs inspected yard and did not observe any hazards. The west side of the backyard has been made inaccessible. The toolshed in the backyard has a key lock. The backyard is now ready for use.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies cited.

Exit interview was conducted with licensee. A copy of this report was provided and discussed. A Notice of Site Visit Form was posted to parent’s board and must be posted for 30 days.

SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019
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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