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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911592
Report Date: 09/08/2021
Date Signed: 09/08/2021 02:38:13 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:MORRIS-MOSSMAN, CANDICE FAMILY CHILD CAREFACILITY NUMBER:
153911592
ADMINISTRATOR:MORRIS-MOSSMAN, CANDICEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 487-6623
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY:14CENSUS: 0DATE:
09/08/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Candice Morris-MossmanTIME COMPLETED:
02:45 PM
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On 09/08/21 Licensee, Candice Morris-Mossman met with Fresno Regional Manager, Rebecca Varela, Licensing Program Manager, Susie Fanning, and Licensing Program Analysts (LPAs) Araceli Gibson and Rene Mancinas. The purpose of today’s meeting is for a Noncompliance Conference.

A copy of the Noncompliance Conference report was given to the Licensee Candice Morris-Mossman at the meeting.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 09/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021
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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