<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543903590
Report Date: 08/21/2019
Date Signed: 08/21/2019 11:48:42 AM

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:AVILA, SOLEDAD FAMILY CHILD CAREFACILITY NUMBER:
543903590
ADMINISTRATOR:AVILA, SOLEDADFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 799-7046
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 7DATE:
08/21/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Soledad Avila - LicenseeTIME COMPLETED:
12:05 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
An unannounced Case Management inspection was conducted today by Licensing Program Analyst (LPA) Jessika Thompson. LPA met with Licensee Soledad Avila and toured the facility. Also present were seven day-care children.

LPA Thompson conducted an unannounced Annual Random inspection on 07/29/19; however, due to computer issues, LPA Thompson was unable to provide Licensee with a copy of the LIC809, LIC809-C, LIC809-D, and LIC 9058 (Appeal Rights) associated to the inspection. On this date, LPA provided Licensee with all related documentation and reports.
Additionally, LPA reviewed the plan of correction associated to the deficiency cited on 07/29/19. Today, the licensee provided proof of a completed Fire & Disaster drill, conducted on 08/20/19, thereby clearing the deficiency previously cited.

LPA provided the licensee with a "Letter of Deficiency Citations Cleared." This letter must be filed in facility for three years and upon request made accessible to the public for review.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, no deficiencies were observed today.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 08/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1