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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910141
Report Date: 08/04/2022
Date Signed: 08/04/2022 10:20:38 AM


Document Has Been Signed on 08/04/2022 10:20 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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:SOTELO, JESSICA FAMILY CHILD CAREFACILITY NUMBER:
543910141
ADMINISTRATOR:SOTELO, JESSICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 967-5601
CITY:TULARESTATE: CAZIP CODE:
93274
CAPACITY:14CENSUS: 0DATE:
08/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Jessica SoteloTIME COMPLETED:
10:30 AM
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On 08/04/2022 An unannounced Case Management inspection was conducted by Licensing Program Analyst (LPA) Nancy Her. LPA met with Licensee, Jessica Sotelo. The initial purpose of today's inspection was to complete an annual random inspection, however, the licensee indicated that she has not taken care of more than one child for several months. Licensee stated she requested to go inactive in May however she never received the paperwork. Licensee stated she would like to go inactive as she is not taking care of children at this time. LPA explained to Licensee that all fees are due and will need to be paid before going inactive. Licensee stated she will pay the fees by 08/04/2022. LIC 9211 was completed.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted and report was reviewed with the facility representative Jessica Sotelo.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 341-5422
LICENSING EVALUATOR NAME: Nancy HerTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:
DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/04/2022
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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