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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910093
Report Date: 08/23/2023
Date Signed: 08/23/2023 10:14:46 AM

Document Has Been Signed on 08/23/2023 10:14 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:GOMEZ NUNEZ, BERTHA FAMILY CHILD CAREFACILITY NUMBER:
153910093
ADMINISTRATOR:GOMEZ NUNEZ, BERTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 778-6903
CITY:MCFARLANDSTATE: CAZIP CODE:
93250
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
08/23/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Bertha Gomez NunezTIME COMPLETED:
10:25 AM
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On 08/23/2023, Licensing Program Analyst (LPA) Jose Penate conducted an unannounced case management inspection due to licensee wanting to switch rooms for the daycare children, currently licensee has main home approved for care and now is wanting to replace main home with the garage converted daycare room. LPA was met by Licensee, Bertha Gomez Nunez (SPANISH Speaking). The purpose of today's inspection is to approve garage conversion made at the residence. LPA observed safe children's toys, books and safe equipment. There is a functioning smoke detector. The room is approved for day care use. Licensee submitted a new sketch for the accessible areas in her home. Licensee also requested to have backyard approved for daycare children and LPA observed a safe area with age appropriate toys for children. Licensee has pets (1 small dog) at this home. Licensee is aware of child safety around pets and accepts responsibility for any action taken by pets.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies cited during today's visit.

Exit interview was conducted with Licensee, Bertha Gomez Nunez.

A Notice of Site Visit form (LIC 9213) and a copy of the todays report was left.

This report shall be made available to the public upon request.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Jose Penate
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
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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