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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911810
Report Date: 01/12/2023
Date Signed: 01/12/2023 09:41:25 AM

Document Has Been Signed on 01/12/2023 09:41 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:RODRIGUEZ, ELIM FAMILY CHILD CAREFACILITY NUMBER:
153911810
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
01/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Elim RodriguezTIME COMPLETED:
09:45 AM
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On 01/12/23, Licensing Program Analyst (LPA) Gloria Reyes conducted a case management inspection. LPA met with Licensee, Elim Rodriguez. The purpose of today's visit is to inspect the backyard which is currently off-limits to children. There are no children in care today.

LPA observed that the patio area that will be used by children has been enclosed by large plywood boards that have been secured to the 2 x 4's. There is one section of the enclosure that can be opened by removing the plastic mesh. Licensee agrees to provide 100 % care and supervision when the children are outside at all times. Children will be escorted through the garage to the patio area. LPA did not observe any hazards in the garage. The patio area may be utilized for children.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency cited.

Exit interview conducted with licensee. A copy of this report was provided and discussed. A Notice of Site Visit Form was posted to parent's board and must remain posted for 30 days.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Gloria Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2023
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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