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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
503808099
Report Date:
08/30/2019
Date Signed:
08/30/2019 03:03:20 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:
CCCDS-MIKE L. PEREZ, JR. CHILD DEVELOPMENT CENTER
FACILITY NUMBER:
503808099
ADMINISTRATOR:
CASTELLANOS, ANA
FACILITY TYPE:
830
ADDRESS:
655 HARDIN ROAD
TELEPHONE:
(209) 862-1605
CITY:
NEWMAN
STATE:
CA
ZIP CODE:
95360
CAPACITY:
18
CENSUS:
DATE:
08/30/2019
TYPE OF VISIT:
Case Management - Incident
UNANNOUNCED
TIME BEGAN:
02:30 PM
MET WITH:
Ana Castellanos
TIME COMPLETED:
03:30 PM
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LPA Claudia Henley conducted a case management inspection today. An incident occurred in the infant/toddler room on 7/1/19 where flooding occurred on the floor due to a plumbing issue.
LPA Henley inspected the infant/toddler room today. The flooring and insulation under the floor have all been replaced and new products installed. The facility is now officially open and able to enroll children at this time.
LPA observed no deficiencies during this inspection visit.
Site Visit Notice posted. Exit interview was conducted.
SUPERVISOR'S NAME:
Alice Juarez
TELEPHONE:
(559) 650-7857
LICENSING EVALUATOR NAME:
Claudia Henley
TELEPHONE:
(559) 341-5776
LICENSING EVALUATOR SIGNATURE:
DATE:
08/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/30/2019
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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