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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543809290
Report Date: 03/18/2022
Date Signed: 03/18/2022 12:26:03 PM


Document Has Been Signed on 03/18/2022 12:26 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:MENDOZA, YOLANDA FAMILY CHILD CAREFACILITY NUMBER:
543809290
ADMINISTRATOR:MENDOZA, YOLANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 804-3506
CITY:LINDSAYSTATE: CAZIP CODE:
93247
CAPACITY:14CENSUS: 0DATE:
03/18/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Yolanda MendozaTIME COMPLETED:
12:30 PM
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On 03/18/2022, Licensing Program Analyst (LPA), Diane Mercado met with Licensee, Yolanda Mendoza for an unannounced case management inspection. LPA toured the facility and a census was taken. An Unusual Incident Report was submitted to the Fresno Community Care Licensing Office (CCL) regarding two incidents that occurred on 03/14/2022 and other date unknown, where three children were potentially having inappropriate physical contact and to discuss with Licensee the need to increase supervision.

Based on the information obtained, this appears to be an isolated incident and Licensee took appropriate measures to address the incident and followed appropriate reporting requirements.



Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted with Licensee, Yolanda Mendoza. This report is to be made available to the public upon request. LIC 9213 Notice of Site Visit to be posted for 30 day.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Diane MercadoTELEPHONE: (559) 341-6334
LICENSING EVALUATOR SIGNATURE:
DATE: 03/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2022
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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