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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 06:29:27 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:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Rosa DelaCruzTIME COMPLETED:
01:30 PM
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LPA Diana Martinez conducted an unannounced case management inspection today and was met by licensee Rosa DelaCruz. There were six day care children present today. The purpose of today's inspection was to inspect the back yard for day care use and to approve an additional bedroom for day care use. Licensee is approved to use bedroom #1 for day care use, specifically napping purposes, effective today, 10/14/19. Licensee provided an updated facility sketch.

Back yard was previously off limits to day care children as two dogs were kept in that space and front yard was used for day care children instead. LPA observed that back yard is free of hazards that may endanger day care children. No bodies of water observed. Licensee’s dogs that previously occupied the full back yard will be kept on the east side of the home in an enclosed dog run and will be kept inaccessible to children. Multiple birds are kept in the accessible part of the back yard in an enclosed cage. Licensee is aware of the safety of children around animals. Licensee is approved to use back yard for day care use, effective today, 10/14/19.

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

An exit interview conducted with licensee Rosa DelaCruz 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: 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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