153905008-10-15-2023-57-CC-PGAA-CWMR44-20231015124055

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153905008
Report Date: 10/13/2023
Date Signed: 10/15/2023 12:40:58 PM

Document Has Been Signed on 10/15/2023 12:40 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:	BENITEZ, AGATHA FAMILY CHILD CARE		FACILITY NUMBER:	153905008
ADMINISTRATOR:	BENITEZ, AGATHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 717-3202
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93314
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	10/13/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Agatha Benitez		TIME COMPLETED:	11:00 AM

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On September 13, 2023 Licensing Program Analyst (LPA) Paul Garcia conducted an unannounced case management visit and met with Licensee Agatha Benitez. A tour of the facility was given, and a census was taken. The purpose of the visit was explained to Licensee.

LPA explained the purpose of the visit was to ensure that Licensee Agatha Benitez was present in the home providing care and supervision to the children. LPA also observed, staff # 1 and staff # 2 to be assisting with care in the home with 10 children present.

LPA confirmed that the facility sketch was current. LPA also followed follow up on a new crib licensee purchased for her smaller children. The crib meets standards and can be used immediately. LPA reviewed Safe Sleep Logs and observed that they were current. There were no excluded individuals in the home.

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA provided Licensee Agatha with technical assistance of the CCLD website and the training's that are available to her.

Per Title 22 Division 12 Chapter 3 of the California Code of Regulations no deficiency's are being cited today.

Report was read and exit interview was conducted with Licensee Agatha Benitez. Notice of Site was provided and must be posted for thirty days.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Paul Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2023

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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