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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910278
Report Date: 10/15/2019
Date Signed: 10/15/2019 03:15:46 PM

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:LOPEZ, JUANA FAMILY CHILD CAREFACILITY NUMBER:
153910278
ADMINISTRATOR:LOPEZ, JUANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 721-0828
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY:14CENSUS: 4DATE:
10/15/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Juana LopezTIME COMPLETED:
03:30 PM
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An unannounced case management inspection was conducted today by Licensing Program Analyst (LPA) Gloria Reyes. LPA met with licensee, Juana Lopez. LPA toured the facility and a census was taken.

The purpose of the visit is to discuss the Legal Order signed and effective on September 24, 2019, and the terms and conditions of the probationary license. A copy of the Decision and Order was given to the licensee at the time of this visit. It was agreed by all parties that the license of Respondent, Juana Lopez, to operate a Family Child Care Home has been revoked. However, the revocation of respondent's license is stayed, for a period of three (3) years from the effective date of this Decision, during which time the Respondent shall be on probation to the Department of Social Services. A probationary license shall be granted subject to the limitations and conditions of the Decision and Order. Limitations and conditions were reviewed with licensee during the visit. Licensee acknowledged she understands and agrees to adhere to all limitations and conditions. It was explained to licensee that a violation of any terms and conditions of this Order shall constitute sufficient grounds for revocation. Attending an Orientation was discussed with licensee to complete an Orientation by December 24, 2019. Licensee also understands that she must complete and submit a proof/certification of completing twelve (12) hours of training related to: 1) Family Child Care Orientation offered by the Department; 2) Care and Supervision; and 3) Reporting Requirements. Licensee shall provide a copy of this Decision and Order to parents of current and future day care children, and advise them of her probationary status. Upon successful completion of probation, then the license shall be restored to unrestricted capacity.

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

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: 10/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019
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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