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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620173
Report Date: 01/29/2024
Date Signed: 01/29/2024 03:01:55 PM

Document Has Been Signed on 01/29/2024 03:01 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
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:VERDUGO, STEPHANIE FAMILY CHILD CAREFACILITY NUMBER:
155620173
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
01/29/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Stephanie VerugoTIME COMPLETED:
12:20 PM
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On January 29, 2024, Licensing Program Analyst (LPA) Paul Garcia conducted an unannounced licensee initiated case management inspection. LPAs met with licensee Stephanie Verugo. A census was taken, and LPA toured the facility inside and out. The purpose for the inspection was to determine if all corrections in the backyard that is off-limits to day-care children have been made per case management visit that took place on November 6, 2023.

LPA inspected the backyard and LPA determined all corrections have been made per inspection that took place on November 6, 2023, however, LPA determined that the following additional areas need to be corrected before the children’s back yard play area is approved for use. Additional corrections shall be completed as follows:

· LPA observed a gate that assists in the separation of the off-limits portion of the back yard from the children’s play yard does not fully close and needs to be adjusted.
· LPA observed a gate that assists in the separation of the off-limits portion of the back yard from the children’s play yard must have the ability to be secured (locked) to prevent children from having access to the off-limits portion of the yard.
· LPA observed buckets, recycle items, lawn equipment, tools and other miscellaneous items that must be organized or discarded.

Licensee is to submit pictures when all work has been completed to LPA. Licensee is to contact LPA when she is has completed the requested corrections. In the meantime, the back yard play area SHALL remain off limits and licensee will continue to use the enclosed front yard for outdoor play. Licensee must continue to provide 100% supervision when children are outside.
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Paul Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/29/2024
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
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: VERDUGO, STEPHANIE FAMILY CHILD CARE
FACILITY NUMBER: 155620173
VISIT DATE: 01/29/2024
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Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency cited.

An exit interview conducted with Licensee, Stephanie Verdugo and a copy of this report was provided and discussed.

A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.

Appeal Rights were discussed and issued.
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Paul Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC809 (FAS) - (06/04)
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