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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 150405419
Report Date: 08/29/2022
Date Signed: 08/29/2022 01:13:25 PM

Document Has Been Signed on 08/29/2022 01:13 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:AGAPELAND CHRISTIAN ACADEMYFACILITY NUMBER:
150405419
ADMINISTRATOR:BANKS, MARISAFACILITY TYPE:
850
ADDRESS:1030 - 4TH STREETTELEPHONE:
(661) 325-4321
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 37DATE:
08/29/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Terra JohnsonTIME COMPLETED:
01:20 PM
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On August 29, 2022 Licensing Program Analyst (LPA) Kari McWilliams conducted a POC visit to clear the deficiency cited on August 26, 2022. LPA McWilliams toured the facility and a census was taken.

Facility representative presented all staff's current certificates for the Mandated Reporter Training.

Exit interview conducted and report was reviewed with the facility representative Terra Johnson.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.
A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Kari McWilliams
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2022
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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