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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203804609
Report Date: 12/06/2022
Date Signed: 12/06/2022 02:38:56 PM


Document Has Been Signed on 12/06/2022 02:38 PM - It Cannot Be Edited

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:COSIO FAMILY CHILD CAREFACILITY NUMBER:
203804609
ADMINISTRATOR:COSIO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 673-1453
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 0DATE:
12/06/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Maria CosioTIME COMPLETED:
02:40 PM
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On December 06, 2022 at 2:00 PM, a Noncompliance Conference (NCC) was conducted at the Fresno Regional Child Care Office to discuss violations of Title 22 regulations.

In attendance at this office visit were: Licensee, Maria Cosio, Licensee's husband Juan Cosio, Fresno Child Care Regional Manager (RM), Rebecca Varela, and Licensing Program Analyst (LPA), Stephanie Vega-Gonzalez

During today's office visit, a copy of the NCC and Acknowledgement of Receipt of Licensing Reports (LIC 9224) was provided to Licensee.

No deficiency was cited during today's office visit. An exit interview was conducted with Licensee, Maria Cosio.

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.
SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2022
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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