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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543905956
Report Date: 05/01/2019
Date Signed: 05/01/2019 10:11:28 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:CABRERA, ANGELA FAMILY CHILD CAREFACILITY NUMBER:
543905956
ADMINISTRATOR:CABRERA, ANGELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 564-9045
CITY:WOODLAKESTATE: CAZIP CODE:
93286
CAPACITY:14CENSUS: 5DATE:
05/01/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Angela CaberaTIME COMPLETED:
10:30 AM
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Licensing Program Analyst's (LPAs) Caroline Harris and Jose Penate conducted a Plan of Correction visit today. LPAs met with Licensee, Angela Cabera.

The purpose of todays visit is to clear deficiencies that were previously cited on 4/3/19. LPAs observed the backyard to be cleaned and free of hazards. The licensee placed keep out of reach items in an inaccessible area and placed metal mesh fencing up. Locks were placed on the storage sheds. Door spinners were observed on inaccessible rooms inside, and keep out of reach items were placed up high or in locked cabinets. A review of children's files showed that all required forms were available for review and an updated roster was also available. The licensee further completed the Mandated Reporter training. The licensee's assistant also updated her CPR/first aid.

During the visit the LPAs provided a Letter of Deficiency Citations Cleared. Exit interview was conducted with Angela Cabera.

Per California Code of Regulations Title 22, Division 12, no deficiency was cited during today's visit.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
A Notice of Site Visit was posted on parent board and shall remain for 30 days.

To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019
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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