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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543810067
Report Date: 07/31/2019
Date Signed: 07/31/2019 02:29:30 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:WEST PUTNAM PS-PUSDFACILITY NUMBER:
543810067
ADMINISTRATOR:REBECCA ORTEGA-ORTIZFACILITY TYPE:
850
ADDRESS:1345 W PUTNAM AVETELEPHONE:
(559) 782-7280
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:24CENSUS: 0DATE:
07/31/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Rebecca Ortiz, DirectorTIME COMPLETED:
02:30 PM
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Licensing Program Analyst Pete Espinoza conducted a Case Management inspection initiated by Licensee. LPA met with Rebecca Ortiz, Director. Purpose of inspection is to follow-up on inspection dated 05/20/2019 regarding center application.

LPA observed classroom proposed for use by preschool children setup with furniture, equipment and materials ready for use by children.

Pending a final file review, a recommendation will be made to license the above facility for a capacity of 24 children.

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: 07/31/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2019
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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