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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543806962
Report Date: 04/13/2022
Date Signed: 04/13/2022 06:39:12 PM


Document Has Been Signed on 04/13/2022 06:39 PM - 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:FLORES, MAYRA FAMILY CHILD CAREFACILITY NUMBER:
543806962
ADMINISTRATOR:FLORES, MAYRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 397-6254
CITY:DINUBASTATE: CAZIP CODE:
93618
CAPACITY:14CENSUS: 0DATE:
04/13/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Mayra FloresTIME COMPLETED:
12:00 PM
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Licensing Program Analyst (LPA) Diana Martinez conducted a case management inspection initiated by Licensee. LPA was met by Licensee Mayra Flores. There were no children were present. The purpose of today's inspection was to approve the recent renovation of the day care room and the addition of the day care restroom. Licensee provided a copy of the City of Dinuba building permit for the 620 square foot residential addition and a new facility sketch. The day care room was renovated, and new addition includes the day care restroom, and the following inaccessible rooms: laundry room, office, master bedroom, master bathroom, and master walk-in closet. The day care room renovations include a ceiling with insulated full walls, new electric outlets, two electric fans and lights, electric AC/heater, thermostat, tile flooring, and French doors. The day care room will be accessed from the exterior of the home through the French doors. The only accessible rooms are the day care room and restroom. Meals are prepared in the kitchen and eaten in the day care room. The off-limit rooms are made inaccessible with child safety plastic door knob covers and a child safety gate placed at kitchen entry. Licensee also submitted permits for other additions/renovations to the home which include a patio cover and new roof.

LPA reviewed the city permits, toured the new day care area, new inaccessible rooms, and exterior of home and found it to be safe for the day care children's use.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies cited during today's visit.

An exit interview was conducted with Licensee Mayra Flores and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D MartinezTELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:
DATE: 04/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2022
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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