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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910940
Report Date: 03/09/2023
Date Signed: 03/09/2023 03:09:00 PM

Document Has Been Signed on 03/09/2023 03:09 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:JACKSON, LOVELY FAMILY CHILD CAREFACILITY NUMBER:
543910940
ADMINISTRATOR:JACKSON, LOVELYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 940-8136
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
03/09/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Lovely JacksonTIME COMPLETED:
03:30 PM
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On 3/9/2023, Licensing Program Analyst (LPA) Theresa Marquez conducted a Case Management inspection and met with licensee Lovely Jackson. Assistant Emma Reyes was also present.

The purpose of this inspection is to tour the garage that was converted into a day care room. The City of Visalia Fire Dept. granted a fire clearance approval of the day care room on 2/15/2023. LPA Marquez toured the day care room. Safe toys and play equipment were observed. The fire extinguishers, smoke detectors, and carbon monoxide detector met Community Care Licensing (CCL) regulations. Heating/cooling and ventilation was sufficient for safety and comfort.

LPA Marquez advised Licensee Jackson the day care room is approved for primary day care use.

An exit interview was conducted and report was reviewed with the Lovely Jackson. A copy of the evaluation report, Appeal Rights and the Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE: DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/09/2023
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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