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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 157200749
Report Date: 09/29/2021
Date Signed: 10/01/2021 11:13:01 AM

Document Has Been Signed on 10/01/2021 11:13 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:MERCIE'S DAY PROGRAMFACILITY NUMBER:
157200749
ADMINISTRATOR:DE CLARO, GERALDFACILITY TYPE:
775
ADDRESS:2700 K STREETTELEPHONE:
(661) 323-5585
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93301
CAPACITY: 49CENSUS: DATE:
09/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:43 PM
MET WITH:TIME COMPLETED:
12:59 PM
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On 8/27/21 Licensing Program Analyst (LPA) M. Garza arrived at facility to conduct an unannounced Infection Control/Annual Inspection. LPA was contacted Administrator, Gerald De Claro but a voicemail was received. A message was left asking for a return call.

LPA sent email to facility email: dayprogram@merciesinc.com with no response. LPA will attempt again later today to complete visit.

LPA returned to facility on 9/27/21 at approximately 3:15 pm. No one was at facility and no one returned call or email to complete visit.

LPA will return at a later date to complete visit.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Mary Garza
LICENSING EVALUATOR SIGNATURE: DATE: 09/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/29/2021
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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