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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503907029
Report Date: 09/10/2020
Date Signed: 09/10/2020 03:07:31 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:GONZALEZ, NANCY FAMILY CHILD CAREFACILITY NUMBER:
503907029
ADMINISTRATOR:GONZALEZ, NANCYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 324-8602
CITY:MODESTOSTATE: CAZIP CODE:
95358
CAPACITY:14CENSUS: 9DATE:
09/10/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Nancy GonzalezTIME COMPLETED:
02:45 PM
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On 09/10/2020, Licensing Program Analyst (LPA) Angelica Mejia, conducted a Licensee initiated case management tele-inspection. Due to COVID-19 and the suspension of in-person visits, LPA conducted a tele-inspection with Licensee Nancy Gonzalez via FaceTime. Licensee is requesting to make bedroom #2, which was previously off-limits to children in care, accessible to daycare children for distance learning activities.

LPA inspected bedroom #2 and observed a tall drawer chest with all drawers empty and an area with various health and beauty items. Licensee stated she will have the drawer chest secured to the wall with a furniture anchor and will remove the health and beauty items. Licensee will provide proof of correction of these two items to LPA before allowing daycare children access to bedroom #2. Licensee can utilize bedroom #2 for daycare children once LPA has received proof of the corrections. LPA did not observe any other safety or security hazards in bedroom #2. “Off-limits” rooms are made inaccessible by doorknob spinners. Licensee provided an updated facility sketch to LPA via text message.

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

An exit interview was conducted with Licensee and a copy of this report and appeal rights were provided via email. Licensee will send a copy of the report signed with her original signature to the Fresno Regional Office.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Angelica MejiaTELEPHONE: (559) 341-6126
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2020
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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