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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808245
Report Date: 12/04/2019
Date Signed: 12/04/2019 10:45:58 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:SCHELBY HEAD START/MERCED CO. OFFICE OF EDUCATIONFACILITY NUMBER:
243808245
ADMINISTRATOR:AGUILAR, TERESAFACILITY TYPE:
850
ADDRESS:6738 NORTH SULTANA DRIVETELEPHONE:
(209) 394-1821
CITY:LIVINGSTONSTATE: CAZIP CODE:
95334
CAPACITY:40CENSUS: 0DATE:
12/04/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Teresa AguilarTIME COMPLETED:
11:00 AM
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An unannounced case management inspection was conducted today by Licensing Program Analysts (LPAs) Ginny Badhesha and Angelica Slaughter. LPAs met with Teresa Aguilar (Site Supervisor) and Letha Martinez (Education Coordinator). During today's inspection LPAs were advised facility is undergoing renovations and children have been moved to others sites (Delhi Head Start and Shattuck Park Head Start). Site Supervisor was advised to let LPA Brannon know as soon all remodeling is completed. Site Supervisor was also advised to stay within ratios at all sites where children have been moved.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, in the areas evaluated no deficiency was cited during today's visit.

A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Gagandip BadheshaTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019
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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