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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910688
Report Date: 04/18/2023
Date Signed: 04/18/2023 09:59:34 AM

Document Has Been Signed on 04/18/2023 09:59 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:QUEVEDO, ELSA FAMILY CHILD CAREFACILITY NUMBER:
153910688
ADMINISTRATOR:QUEVEDO, ELSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 396-6354
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93305
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
04/18/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Maria QuevadoTIME COMPLETED:
10:00 AM
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On 04/18/2023 Licensing Program Analysts (LPAs) Nancy Her and Denisia Jimenez, conducted an unannounced Plan of Correction visit and was met by Assistant Maria Quevado. Also present was Staff #1. Assistant is Spanish Speaking and LPA Jimenez assisted with interpretation.

On 03/28/2023, Licensee was cited for the backyard fence being warped and not maintained in a safe condition which posed a potential health, safety, or personal rights risk to persons in care.

Licensee was also cited for several children's files missing immunization records to verify that children are immunized against diseases, not having identification and emergency information card for several children in care, and not having a current roster of children.

During today’s inspection, LPAs inspected the backyard fencing and reviewed missing documentation. The backyard fencing is in good condition and is found to be in a safe condition. Children’s files contain immunization records, identification and emergency information, and Licensee has a current roster of children. Plan of corrections were cleared on today’s date.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted and report was reviewed with the facility representative Maria Quevado.

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Nancy Her
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2023
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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