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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911678
Report Date: 01/19/2022
Date Signed: 01/19/2022 06:04:43 PM

Document Has Been Signed on 01/19/2022 06:04 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:SAUCEDA, SANDRA FAMILY CHILD CAREFACILITY NUMBER:
103911678
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
01/19/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sandra SaucedaTIME COMPLETED:
09:45 AM
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On 01/19/2022 a planned second pre-licensing inspection was made today by Licensing Program Analyst (LPA) Rene Mancinas, who met with Applicant, Sandra Sauceda. A tour of the home’s inside, as shown on the facility sketch was done. Purpose of the inspection was to ensure the following correction(s) were made:

Before Licensure the following items are to be corrected to avoid the application from being withdrawn:

1. Applicant is to install 5-ft fencing in areas where home windows have direct access to the pool area.

2. Applicant is to ensure pool gate is self-latching, with minimal effort. (i.e. place a tension spring and self-latch on gate).

The above items were corrected and verified during today's inspection.

This home meets the description of a safe and healthy environment for children as described in Chapter 3, Division 12, Title 22 of California Code of Regulations and licensure for a capacity of up to eight children. Licensure as a Small Family Child Care Home capacity of eight children* ages under 18 years, will be recommended effective 01/19/2022. Planned hours of operation are Monday through Friday from 06:00AM - 05:30PM, and as arranged.

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: Susie Fanning
LICENSING EVALUATOR NAME: Rene Mancinas
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2022
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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