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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543909145
Report Date: 03/08/2022
Date Signed: 03/08/2022 11:43:59 AM


Document Has Been Signed on 03/08/2022 11:43 AM - It Cannot Be Edited

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:BERMUDEZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
543909145
ADMINISTRATOR:BERMUDEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 781-4214
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:14CENSUS: 3DATE:
03/08/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Maria Bermudez, LicenseeTIME COMPLETED:
12:00 PM
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On 03/07/2022, a Case Management Inspection - Licensee Initiated was conducted today by Licensing Program Analyst, Pete Espinoza. LPA met with, Maria Bermudez, Licensee. LPA spoke with Licensee regarding required fencing between window/door of home that are exposed to pool area.

LPA informed Licensee of requirement to have barrier/fence between window/door of home and pool. LPA advised Licensee to install temporary fence that will allow a access/path at minimum of 36 inches from window/door from window to pool gate. LPA informed Licensee that fence is to be installed per title 22 regulations (at least five feet high and constructed so that the fence does not obscure the pool from view). LPA Informed Licensee a fire inspection will be required upon completion of installation of fence.

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

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

To order forms, etc. visit our website at www.ccld.ca.gov.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2022
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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