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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163911009
Report Date: 10/16/2019
Date Signed: 10/16/2019 04:51:08 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:CERVANTES, LETICIA FAMILY CHILD CAREFACILITY NUMBER:
163911009
ADMINISTRATOR:CERVANTES, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 836-3691
CITY:HANFORDSTATE: CAZIP CODE:
93230
CAPACITY:14CENSUS: 0DATE:
10/16/2019
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Leticia CervantesTIME COMPLETED:
05:05 PM
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A planned second Prelicensing inspection was made today by Licensing Program Analyst (LPA) Daniel Alvarez, who met with Applicant Leticia Cervantes. A tour of the home, inside and outside, as shown on the facility sketch was done. Purpose of the inspection was to ensure the following correction(s) were made:

1. Applicant needs to bring her in-ground swimming pool fence within title 22 regulation regarding accessible bodies of water. Currently there are sections of her pool fencing where there is more than a two inch gap/space between the fence and the ground. Currently the gate is not self latching as well.

Applicant has brought her swimming pool fence within title 22 pool fence regulations.

This home meets the description of a safe and healthy environment for children as described in Chapter 3, Division 12, Title 22 of California Code of Regulations and licensure for a capacity of up to 14 children. Pending a final review of your application, licensure as a Large Family Child Care Home capacity of 14 children* ages under 18 years, will be recommended effective 10/18/2019. Planned hours of operation are Monday through Friday from 7:00 AM to 6:00 PM and as arranged.

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: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
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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