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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 107200790
Report Date: 12/20/2024
Date Signed: 12/20/2024 10:24:14 AM

Document Has Been Signed on 12/20/2024 10:24 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 RO, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:CLOVIS QUALITY CARE IIFACILITY NUMBER:
107200790
ADMINISTRATOR/
DIRECTOR:		STAGGS, PATRICIAFACILITY TYPE:
740
ADDRESS:944 N. CHAPEL HILLTELEPHONE:
(559) 322-1220
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY: 7TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
12/20/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:34 AM
MET WITH:Licensee-Nina GarciaTIME VISIT/
INSPECTION COMPLETED:
10:40 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
On 12/20/24, Licensing Program Analyst (LPA) J. Leffall conducted a case management visit to follow up on staff who are not associated to the facility. Staff Antonia Garcia, Mark Fuentes, Phoeun Marez were present. Licensee-Nina Garcia arrived after and is not associated.

LPA inquired about who is the current Licensee of the facility in charge of operations.

Deficiency for fingerprint clearance or association is on the attached LIC-809-D. Immediate Civil Penalty assessed for all 4 individuals.

Appeal rights issued and exit interview conducted.
See MouaTELEPHONE: (559) 580-4596
Jacques LeffallTELEPHONE: 559-243-8080
DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2024
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