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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910471
Report Date: 10/21/2019
Date Signed: 10/21/2019 09:55:21 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:POMPA-NAVARRO, MARCELINA FAMILY CHILD CAREFACILITY NUMBER:
543910471
ADMINISTRATOR:POMPA-NAVARRO, MARCELINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 791-5445
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:14CENSUS: 7DATE:
10/21/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Marcelina Pompa-Navarro, LicenseeTIME COMPLETED:
10:00 AM
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
LPA Pete Espinoza conducted Plan of Correction visit today regarding deficiencies cited on 08/29/2019. LPA met with Marcelina Pompa-Navarro, Licensee.

LPA reviewed updated Facility Roster (LIC 9040). LPA instructed Licensee to include date of birth for all children enrolled. LPA instructed Licensee to include all children enrolled who have terminated services AND include date of termination of services on Facility Roster.

During visit LPA provided Letter of Deficiency Citations Cleared. Exit interview conducted with Marcelina Pompa-Navarro, Licensee.

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.

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: 10/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2019
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