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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243909641
Report Date: 09/20/2021
Date Signed: 09/20/2021 01:35:18 PM

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:LINARES, LAURA FAMILY CHILD CAREFACILITY NUMBER:
243909641
ADMINISTRATOR:LINARES, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 580-4657
CITY:MERCEDSTATE: CAZIP CODE:
95341
CAPACITY:14CENSUS: 2DATE:
09/20/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Laura Linares - LicenseeTIME COMPLETED:
01:45 PM
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On 9/20/21, Licensing Program Analyst (LPA) Joseph Pacheco conducted an unannounced case management inspection. LPA met with Licensee to discuss Community Care Licensing (CCL) regulations. LPA discussed the purpose of the inspection with Licensee and obtained a census. Also present was Licensee's Assistant. Children present were too young to be interviewed.

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

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit Form is required to be posted for 30 days.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2021
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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