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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543902082
Report Date: 10/14/2019
Date Signed: 10/14/2019 06:20:37 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:DELACRUZ, ROSA FAMILY CHILD CAREFACILITY NUMBER:
543902082
ADMINISTRATOR:DELACRUZ, ROSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 591-8096
CITY:DINUBASTATE: CAZIP CODE:
93618
CAPACITY:14CENSUS: 6DATE:
10/14/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Rosa DelaCruzTIME COMPLETED:
12:00 PM
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An unannounced Plan of Correction inspection was conducted by Licensing Program Analyst (LPA) Diana Martinez with licensee Rosa DelaCruz. LPA toured the facility inside and outside and census taken. The purpose of today's inspection is to clear the deficiencies cited during the annual inspection conducted on 9/13/19. On 9/13/19, licensee was cited for not having a current roster, having two off-limits rooms accessible to daycare children, and misplacing files for three children.

During the inspection conducted today, LPA visually confirmed that all deficiencies have been corrected. Licensee is aware that going forward she is to maintain a current roster, ensure that all off-limits rooms remain inaccessible, and will only accept children for care after receipt of all required children’s forms including immunization records.

Deficiencies cited on 9/13/19 are now cleared. Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies cited during today's visit.

Exit interview was conducted with licensee Rosa DelaCruz. A Notice of Site Visit Form was posted to parent’s board and must be posted for 30 days. This report shall be available for public review upon request.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D MartinezTELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2019
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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