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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163910611
Report Date: 05/28/2020
Date Signed: 02/19/2021 08:48:35 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:HOLE, ALICE FAMILY CHILD CAREFACILITY NUMBER:
163910611
ADMINISTRATOR:HOLE, ALICEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 816-7787
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:14CENSUS: DATE:
05/28/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Alice HoleTIME COMPLETED:
12:15 PM
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On 5/28/2020, Licensing Program Analyst (LPA) Kathy Pacheco conducted a virtual case management inspection with Licensee, Alice Hole, via Face Time, due to COVID-19 restrictions.

The inspection was to observe the back yard of the home that was previously off-limits to day care children. Licensee provided LPA with a virtual inspection of the back yard. LPA observed a swimming pool that was surrounded by a five foot, mesh fence that meets Title 22 regulation requirements and has a self-latching gate that swings away from the swimming pool. Licensee stated the day care children may have access to the swimming pool. Licensee was reminded that full supervision is required outdoors when children are utilizing the swimming pool.

LPA also observed a trampoline that is not used for day care children. LPA advised Licensee to place a lock at the opening of the trampoline netting so children do not have access to the trampoline. Licensee agreed to get a lock for the trampoline netting.

Based on the LPA's observations during the virtual inspection, the back yard may now be utilized by day care children.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency was cited during the inspection.

Exit interview was conducted with Licensee. LPA advised Licensee a copy of the Facility Evaluation Report (LIC 809), as well as, the Notice of Site Visit (LIC 9213) would be emailed to Licensee. LPA requested for Licensee to sign the LIC 809 and return the signed copy to LPA. Licensee was also reminded the LIC 9213 needs to be posted for 30 days.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2020
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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