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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243903395
Report Date: 01/20/2023
Date Signed: 01/20/2023 12:56:23 PM


Document Has Been Signed on 01/20/2023 12:56 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:VAZQUEZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
243903395
ADMINISTRATOR:VAZQUEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 382-1125
CITY:LEGRANDSTATE: CAZIP CODE:
95333
CAPACITY:14CENSUS: 9DATE:
01/20/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Maria VazquezTIME COMPLETED:
01:00 PM
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On 01/20/2023, Licensing Program Analyst (LPA) Jeovanna Yanez conducted an unannounced Case Management inspection to inspect a new room addition to the home. Licensee has previously provided LPA with a copy of the building permit issued by the City of LeGrand. LPA toured the facility and reviewed the new addition to the home. Fresno Regional Office received fire clearance approved by City of Merced Fire Department, for use of new room addition in day-care on 12/5/2022.

LPA inspected the room addition and has determined it is safe for day-care children to use and may be used immediately. The new room addition also includes a small kitchen area which will be off-limit by use of safety gate, and a bathroom. The areas of the home that day-care children will now have access to are the living room, dining room, bedroom #1, hallway bathroom, new daycare room, and new daycare bathroom. Licensee submitted a copy of updated Facility Sketch (LIC 999) showing room addition during the inspection.

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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