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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543905261
Report Date: 02/12/2020
Date Signed: 02/12/2020 12:43:42 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:RODRIGUEZ, MARIA & JANET FAMILY CHILD CAREFACILITY NUMBER:
543905261
ADMINISTRATOR:RODRIGUEZ, MARIA & JANETFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 784-0148
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:14CENSUS: 3DATE:
02/12/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Janet Rodriguez LicenseeTIME COMPLETED:
12:45 PM
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A case management inspection was conducted today by Licensing Program Analyst, Pete Espinoza. LPA met with Janet Rodriguez Licensee, to discuss reported incident which occurred on 11/14/2019. A complete file review was conducted prior to visit. LPA toured facility inside and outside. Census was taken. LPA interviewed staff.

Licensee stated on 11/08/2019, Detective with Porterville Police Department (PD) came to the facility to interview Licensee and her father regarding a complaint filed with the PD. Licensee stated PD interviewed herself and her father. Licensee stated she had not heard from PD since the day they came to interview her and her father. Licensee stated no one else (CPS, etc.) has discussed the incident with her.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit. Exit interview conducted with the Janet Rodriguez, Licensee.

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: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2020
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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