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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503608712
Report Date: 08/10/2022
Date Signed: 08/10/2022 02:50:43 PM

Document Has Been Signed on 08/10/2022 02:50 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:VIGIL, LETICIA FAMILY CHILD CAREFACILITY NUMBER:
503608712
ADMINISTRATOR:VIGIL, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 872-2820
CITY:MODESTOSTATE: CAZIP CODE:
95358
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
08/10/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Leticia VigilTIME COMPLETED:
02:50 PM
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On 8/10/22, LPA Priscilla Zamudio completed an unannounced visit and met with Licensee Leticia Vigil. Also present was licensee's husband, and assistant, Michael Vigil. This visit was made to inspect the garage conversion.

Days and hours of operation are Monday through Friday 8:30 AM – 5:30 PM.

The Fire Department has already been to this home & given a fire clearance for the garage conversion. After inspecting the conversion it is determined that this room does meet the California Code of Regulation (CCR), Title 22 requirements.

During exit interview the Notice of Site Visit LIC 9213 was discussed and left for 30 day posting.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Priscilla Zamudio
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2022
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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