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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620173
Report Date: 02/26/2024
Date Signed: 02/26/2024 05:03:29 PM

Document Has Been Signed on 02/26/2024 05:03 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: 3DATE:
02/26/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Stephanie VerdugoTIME COMPLETED:
11:15 AM
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On February 26, 2024, Licensing Program Analyst (LPA) Paul Garcia conducted an unannounced case management visit and met with Licensee Stephanie Verdugo. A tour of the facility was given, and a census was taken.

This visit was initiated by licensee during the visit to inspect one (1) Bathroom that was previously off limits. Licensee requested to use her sick room connected bathroom for use when needed by the older children when the primary bathroom is being occupied by the smaller children in care.

A clean serviceable bathroom was observed, and LPA determined the area was safe for children in care. No poisons nor chemicals were observed. Child safety latches were present and functional.

LPA confirmed that the new facility sketch that was received during visit matched licensees sketch to ensure the accuracy of the areas being used.

LPA approves the bathroom. Children can now utilize the area effective immediately.

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

Report was provided and an exit interview was conducted with Licensee Stephanie. Notice of Site was provided and must be posted for thirty days.
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Paul Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2024
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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