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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503808972
Report Date: 11/13/2019
Date Signed: 11/13/2019 01:32:11 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:LITTLE LIGHTS PRESCHOOLFACILITY NUMBER:
503808972
ADMINISTRATOR:MATZKIND, CAROLFACILITY TYPE:
850
ADDRESS:1660 ARBOR WAYTELEPHONE:
(209) 668-2548
CITY:TURLOCKSTATE: CAZIP CODE:
95380
CAPACITY:45CENSUS: 12DATE:
11/13/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Carol MatzkindTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Brannon met with director, Carol Matzkind. During today's visit, LPA spoke with director and received a copy of child roster.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit. Exit interview conducted with director, Carol Matzkind. A copy of this report need to be placed in facility file for public review. A Notice of Site Visit was posted on parent board.

A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019
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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