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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810257
Report Date: 01/31/2024
Date Signed: 01/31/2024 08:28:23 AM

Document Has Been Signed on 01/31/2024 08:28 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:INCLUSION LEARNING CENTER-CLOVIS HILLS CHURCHFACILITY NUMBER:
103810257
ADMINISTRATOR:MONICA PETERSONFACILITY TYPE:
850
ADDRESS:10590 N WILLOW AVETELEPHONE:
(559) 360-5090
CITY:CLOVISSTATE: CAZIP CODE:
93619
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 0DATE:
01/31/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Monica Peterson - DirectorTIME COMPLETED:
08:30 AM
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On 1/31/24, Licensing Program Analysts (LPAs) Joseph Pacheco and Yesenia Fierro conducted an announced pre-licensing inspection and met with Director, Monica Peterson. LPA reviewed the reason of the inspection, and a tour of the center was conducted inside.

During today's inspection, LPA verified the following items have been corrected:

Inside Daycare:
1) Anchor play equipment in the corner to prevent from tipping over.
2) Obtain and install a working carbon monoxide detector.

Pending a final file review, a recommendation will be made to license the above facility for the requested capacity of 15 preschool children.

Exit interview conducted and report was reviewed with Director, Monica Peterson. A copy of this report is to remain in the facility for public review. This report shall be made available to the public upon request.

To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISORS NAME: Deborah Lowe
LICENSING EVALUATOR NAME: Joseph Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/31/2024
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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