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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163909944
Report Date: 06/30/2021
Date Signed: 06/30/2021 03:04:32 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:MORALES, GRACIELA FAMILY CHILD CAREFACILITY NUMBER:
163909944
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
06/30/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Graciela MoralesTIME COMPLETED:
03:15 PM
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On 06/30/2021 Licensing Program Analyst (LPA) Daniel Alvarez conducted a Case Management inspection in regards to increasing capacity. LPA met with Licensee Graciela Morales. A tour of the home, inside and outside, as shown on the facility sketch was done. Day care equipment was evaluated. LPA observed a working fire extinguisher, working smoke detectors and carbon monoxide detector and an adequate first aid kit. During inspection, LPA reviewed fire drill log requirements. The home has been given fire clearance by the Fire Department with jurisdiction to the facility, and has forwarded documentation to CCL.
Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
The home, grounds and equipment meet Chapter 3, Division 12, Title 22 of California Code of Regulations and adequate for a Large Family Child Care Home. Pending a final review of the application, licensure as a Large Family Child Care Home capacity of 14 children* ages under 18 years, will be recommended effective 07/01/2021.
A copy of this report is to remain in the facility 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
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Daniel Q AlvarezTELEPHONE: (559) 341-8684
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021
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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