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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153908434
Report Date: 03/07/2022
Date Signed: 03/07/2022 03:20:44 PM

Document Has Been Signed on 03/07/2022 03:20 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:PATINO, MARIA FAMILY CHILD CAREFACILITY NUMBER:
153908434
ADMINISTRATOR:PATINO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 319-2180
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
03/07/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Maria Patino TIME COMPLETED:
03:35 PM
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On this date, 03/07/22 an unannounced Case Management - Plan of Correction (POC) Inspection was conducted by Licensing Program Analyst (LPA) Araceli Gibson. Licensee had notified LPA deficiencies were ready to be cleared. Licensee has four children in care on today’s inspection. LPA met with Licensee to review the POC associated to deficiencies cited on 01/24/22. Today, LPA verified the following:

· Licensee maintains children’s files complete with LIC 700, LIC 995A LIC 627 and immunizations for the 3 children she was cited for on 01/24/22
.
LPA cleared deficiencies on this date 03/07/22 and provided Licensee with a "Letter of Deficiency Citations Cleared." This letter must be filed in the facility for three years and upon request made accessible to the public for review.

Per California Code of Regulations Title 22, Division 12, Chapter 3 no deficiency cited during today's visit. Exit interview conducted with the Licensee.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2022
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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