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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203907332
Report Date: 05/15/2019
Date Signed: 05/15/2019 03:04:48 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:SARACINO, MARTA FAMILY CHILD CAREFACILITY NUMBER:
203907332
ADMINISTRATOR:SARACINO, MARTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 474-8792
CITY:MADERASTATE: CAZIP CODE:
93637
CAPACITY:14CENSUS: DATE:
05/15/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Marta SaracinoTIME COMPLETED:
03:10 PM
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LPA conducted an unannounced Case Management inspection for the purpose of correcting language on the Annual /Random report dated 05/15/19. LPA met with Licensee Marta Saracino.

The written language on the report read: All adults who reside or work in the home did not have a criminal record clearance or exemption.

The correct language on the report should have read: All adults who reside or work in the home have a criminal record clearance or exemption.

Licensee verified fingerprint clearances on LIS531. There are no uncleared adults residing or working in the home.

LPA provided a copy of this report to the licensee.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019
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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