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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543805116
Report Date: 10/17/2019
Date Signed: 10/17/2019 04:17:48 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:ESPERANZA'S DAY CAREFACILITY NUMBER:
543805116
ADMINISTRATOR:RAMIREZ, LETICIA & JOSEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 636-0812
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 13DATE:
10/17/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Leticia & Jose Ramirez - LicenseesTIME COMPLETED:
04:30 PM
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On this date, an unannounced Case Management - Plan of Correction (POC) Inspection was conducted by Licensing Program Analysts (LPAs) Jessika Thompson and Daniel Alvarez. LPAs met with Licensee’s Leticia and Jose Ramirez to review the POCs associated to deficiencies cited on 09/26/19. Licensees are primarily Spanish speaking; therefore, LPA Alvarez provided translation services. Today, LPAs verified the following:
  • Licensees provided LPAs with a statement outlining the method they have adopted to ensure they stay within their licensed capacity of 14 children
  • Licensees maintain Emergency Medical Consent (LIC 627) forms for children in care

LPAs cleared deficiencies on this date and provided licensee with a "Letter of Deficiency Citations Cleared." This letter must be filed in the facility for three years and upon request made accessible to the public for review.

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

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
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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