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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 223910603
Report Date: 07/30/2019
Date Signed: 07/30/2019 10:19:54 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:MUNSON, KENDRA FAMILY CHILD CAREFACILITY NUMBER:
223910603
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
07/30/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Kendra MunsonTIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Brannon conducted a Proof of Correction (POC) inspection. LPA met with licensee, Kendra Munson.

Previously, licensee was cited on 4/22/19 and 6/26/19 for not maintaining children's records as required in Title 22 regulations. During today's inspection, licensee provided complete children's files. LPA provided a copy of Letter of Deficiency Citations Cleared during today's visit.

Per California Code of Regulations Title 22, no deficiency cited during today's visit. Exit interview conducted with the licensee, Kendra Munson. A copy of this report shall be placed in facility file for public review. A Notice of Site Visit was posted on parent board.

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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2019
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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