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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153902186
Report Date: 11/09/2023
Date Signed: 11/13/2023 01:47:24 PM

Document Has Been Signed on 11/13/2023 01:47 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:MARTINEZ, ANA & TERESA FAMILY CHILD CAREFACILITY NUMBER:
153902186
ADMINISTRATOR:MARTINEZ, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 835-9904
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/09/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:TIME COMPLETED:
02:50 PM
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On November 09, 2023 Licensing Program Analysts (LPAs) Gloria Reyes and Lady Cabrera attempted to conduct an unannounced case management to review the plan of corrections associated to deficiencies cited on 10/27/2023. LPA rang the door bell, knocked on the metal screen door and there was no answer. LPA called the phone number provided to the Department and left a voice message.

LPAs did not observe any children present; there were no sounds of children.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE: DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/09/2023
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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