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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543908443
Report Date: 11/28/2022
Date Signed: 11/28/2022 01:11:02 PM


Document Has Been Signed on 11/28/2022 01:11 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:PENA, JANIE FAMILY CHILD CAREFACILITY NUMBER:
543908443
ADMINISTRATOR:PENA, JANIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 741-1966
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 0DATE:
11/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Janie PenaTIME COMPLETED:
01:15 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
On November 28, 2022 Licensing Program Analyst (LPA) Kari McWilliams attempted to conduct an unannounced annual inspection at the facility. Upon arrival, Licensee Janie Pena informed LPA McWilliams that she is not operating her in home day care and has no children enrolled in her daycare. Licensee stated that she has not been operating since June 1, 2021 and referred all of the children enrolled in her daycare to other facilities. LPA McWilliams toured the facility and there were no children present.

LPA McWilliams provided technical assistance to Licensee regarding placing her license inactive; Licensee stated that she would like to go inactive. LPA McWilliams provided Licensee with the Request for Inactive form LIC 9211 and Licensee filled it out and returned the completed form to LPA McWilliams.

There are no were no issues to report at this time.
SUPERVISOR'S NAME: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:
DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/28/2022
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