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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911755
Report Date: 04/26/2022
Date Signed: 04/26/2022 02:25:24 PM

Document Has Been Signed on 04/26/2022 02:25 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:CHAVEZ OROZCO, ADRIANA FAMILY CHILD CAREFACILITY NUMBER:
153911755
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/26/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Adriana Chavez OrozcoTIME COMPLETED:
02:45 PM
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A second announced pre-licensing inspection was conducted today by Licensing Program Analyst (LPA), Norma Lomeli. Met with Spanish-speaking Applicant, Adrian Chavez Orozco. Applicant, her husband, her adult son and one minor child reside in the home. The purpose of today's inspection is to inspect the following corrections were made.
  • LPA inspected three bedrooms and the master bathroom. The three bedrooms will be kept under key-lock during day care hours.
  • LPA observed two windows and one door from the side run of the home that had direct access to the in-ground pool. Applicant has installed a white rod iron gate on the side run of the home that is self closing/self latching and meets Title 22 Regulations.
  • LPA observed a window from the home that had direct access to the in-ground pool. Applicant replaced the window that had direct access to the in-ground pool with a fixed a window.
  • LPA observed the two pool gates are now self latching/ self closing.


Above items were corrected and verified during today’s inspection.

This home meets the description of a safe and healthy environment for children as described in Chapter 3, Division 12, Title 22 of California Code of Regulations and licensure for a capacity of up to 8 children.

(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CHAVEZ OROZCO, ADRIANA FAMILY CHILD CARE
FACILITY NUMBER: 153911755
VISIT DATE: 04/26/2022
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Planned hours of operation are Monday through Friday from 5:30am to 5:30pm and as arranged

Licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended effective April 27, 2022.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022
LIC809 (FAS) - (06/04)
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