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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543805216
Report Date: 10/14/2021
Date Signed: 10/14/2021 10:40:38 AM

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 RASCALSFACILITY NUMBER:
543805216
ADMINISTRATOR:RATCLIFFE, ALICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 782-1175
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:14CENSUS: 7DATE:
10/14/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Alicia Radcliffe, LicenseeTIME COMPLETED:
10:45 AM
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On 10/15/2021, LPA Pete Espinoza conducted Plan of Correction visit regarding deficiencies cited on 08/10/2021. LPA met with Alicia Ratcliffe, Licensee.

Licensee provided proof completed records for each child enrolled in day-care. Records included Identification and Emergency Information (LIC 700), Consent for Medical Treatment (LIC 627), Notification of Parents' Rights (LIC 995A) & Immunization Records.

Licensee provided for review, updated Facility Roster (9040).

During visit LPA provided Letter of Deficiency Citations Cleared. Exit interview conducted with Alicia Ratcliffe, Licensee.

Per California Code of Regulations Title 22, Division 12, no deficiency was cited during today's visit.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
A Notice of Site Visit was posted on parent board.

To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021
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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