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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503911528
Report Date: 06/22/2021
Date Signed: 06/22/2021 12:01:31 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:ZITKOVICH, MARIO FAMILY CHILD CAREFACILITY NUMBER:
503911528
ADMINISTRATOR:ZITKOVICH, MARIOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 620-3949
CITY:TURLOCKSTATE: CAZIP CODE:
95382
CAPACITY:14CENSUS: 0DATE:
06/22/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Mario Zitkovich TIME COMPLETED:
12:15 PM
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A second announced pre-licensing/change of location inspection was conducted today by Licensing Program Analyst (LPA), Norma Lomeli. Met with Applicant's Assistant, Karina Diaz. Applicant, his wife and their adult daughter reside in the home.

The purpose of today's visit is to verify that the following correction requested was made. LPA observed the following today:
  • LPA measured the black rod iron fence. The fence is five feet high and the gate swings away from the in-ground pool. The self-latching device is located no more than six inches from the top of the gate. The in-ground pool fence meets Title 22 Regulations.

The home meets the description of a safe and healthy environment for children as described in Chapter 3, Division 12, Title 22 of the California Code of Regulations and is adequate for a Large Family Day Care Home (LFDCH). Licensure as a Large Family Day Care Home capacity of 14 children will be recommended effective June 23, 2021.

* Planned hours of operation are Monday through Friday from 7:00 AM to 5:00 PM.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma LomeliTELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:

DATE: 06/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021
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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