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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910573
Report Date: 10/15/2021
Date Signed: 10/15/2021 12:02:39 PM

Document Has Been Signed on 10/15/2021 12:02 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:JAMES, ROSIE FAMILY CHILD CAREFACILITY NUMBER:
153910573
ADMINISTRATOR:JAMES, ROSIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 664-6953
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
10/15/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Rosie JamesTIME COMPLETED:
01:00 PM
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On 10/15/21 Licensing Program Analyst (LPA) Caroline Harris conducted a Plan of Correction inspection. LPA met with Rosie James and toured the home. A census was taken.
The purpose of todays inspection is to review staff files per deficiency cited on 9/27/21. LPA reviewed staff files and observed copies of all required licensing forms and immunizations in each of the staff's files.

During today’s inspection, LPA provided a Letter of Deficiency Citations Cleared. Exit interview was conducted with Rosie James. Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, no deficiency was cited during today’s inspection.

A copy of this report and LIC 9213 Notice of Site Inspection were provided to the licensee Rosie James. This report shall be made available to the public upon request. LIC 9213 Notice of Site Inspection is required to be posted for 30 days.

To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2021
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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