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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203910211
Report Date: 12/12/2022
Date Signed: 12/12/2022 09:44:58 AM


Document Has Been Signed on 12/12/2022 09:44 AM - 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:CORTES, MIRIAM FAMILY CHILD CAREFACILITY NUMBER:
203910211
ADMINISTRATOR:CORTES, MIRIAMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 240-1604
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 1DATE:
12/12/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Miriam CortesTIME COMPLETED:
10:00 AM
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On 12/12/2022, Licensing Program Analysts (LPA) Stephanie Vega-Gonzalez conducted an unannounced case management visit on this date. This case management is based on the 11/29/2022 annual inspection that was completed from 9:46am to 12:25pm. The purpose of the inspection was to inspect the “off-limits” backyard that was made effective on 11/29/2022. Today, LPA met with licensee Miriam Cortes. LPA toured the facility, and a census was taken of 1 child in care. Assistant #2 was also present.

On today's visit, LPA observed that gas riding lawn mower, and lawn mower were made inaccessible by an orange plastic mesh barrier/fence around the patio of the shed. LPA did not observe the pile of wood panels, a metal fence with sharp edges, metal panel, and wood panels with nails behind the shed. Licensee stated that all those materials were dumped and are not within the facilities premises.

Effective today, 12/12/2022, the facility may begin using the back yard for day care children.


Exit interview conducted and report was reviewed with Licensee Miriam Cortes

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited today.

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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