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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243804280
Report Date: 01/20/2023
Date Signed: 01/20/2023 01:28:43 PM


Document Has Been Signed on 01/20/2023 01:28 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:NOT THE MAMA DAY CAREFACILITY NUMBER:
243804280
ADMINISTRATOR:HERNANDEZ, BERTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 631-1226
CITY:PLANADASTATE: CAZIP CODE:
95365
CAPACITY:14CENSUS: 0DATE:
01/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Bertha HernandezTIME COMPLETED:
01:30 PM
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On 01/20/2023, Licensing Program Analyst (LPA) Jeovanna Yanez conducted an unannounced Case Management inspection to follow up on facility's operational status due to the Merced County 2023 Floods. LPA met with Licensee, Bertha Hernandez. No children were present during the inspection.

Licensee stated she received an evacuation order on evening of 1/9/2023, but she closed her facility and evacuated her house on 1/10/2023. Licensee stated she returned to her home on 1/18/2023 once the evacuation order was lifted and power/water were turned back on. Licensee stated no structural damage was observed in her house. No children were present during the evacuation. Licensee is operating as usual now, with no issues to report.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, no deficiencies were found during today's inspection. Exit interview conducted with the Licensee.

LIC 9213 Notice of Site Visit form is required to be posted for 30 days.
SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jeovanna YanezTELEPHONE: (559) 341-5629
LICENSING EVALUATOR SIGNATURE:
DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/20/2023
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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