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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543803079
Report Date: 06/03/2022
Date Signed: 06/03/2022 11:41:37 AM


Document Has Been Signed on 06/03/2022 11:41 AM - 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:TERESA'S DAY CAREFACILITY NUMBER:
543803079
ADMINISTRATOR:DURAN, TERESAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 732-7057
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 4DATE:
06/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Teresa DuranTIME COMPLETED:
11:45 AM
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On June 3, 2022 Licensing Program Analyst (LPA) Kari McWilliams conducted a Case Management visit to deliver an "amended report", LIC9099. Prior visit was made on May 2, 2022, see LIC9099 dated May 2, 2022. LPA toured the facility inside and out and a census was taken.

LPA McWilliams and Licensee discussed amended report; report went from "Confidential" to "Public" LPA and Licensee signed the amended report. Copies of signed reports and appeal rights were left with facility representative.


Per Title 22, Division 12, Chapter 3, no deficiencies are being cited. Exit interview conducted with Licensee Teresa Duran. Notice of Site Visit Form to be posted to parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7980
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:
DATE: 06/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/03/2022
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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