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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163911682
Report Date: 07/11/2024
Date Signed: 07/11/2024 10:25:10 AM

Document Has Been Signed on 07/11/2024 10:25 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:REBOLLEDO, YADIRA FAMILY CHILD CAREFACILITY NUMBER:
163911682
ADMINISTRATOR/
DIRECTOR:		REBOLLEDO, YADIRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 383-4082
CITY:AVENALSTATE: CAZIP CODE:
93204
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
07/11/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Yadira RebolledoTIME VISIT/
INSPECTION COMPLETED:
10:40 AM
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On 07/11/2024, Licensing Program Analyst (LPA) Lady Cabrera conducted an unannounced case management inspection. LPA Cabrera met with Licensee Yadira Rebolledo and also Licensee's husband/assistant was present. Upon arrival, a census was taken, and LPA toured the facility inside and outside. This visit was initiated by Yadira Rebolledo regarding the installation of a new play structure.

LPA inspected the front yard play structure and observed that the recommended age use is for children ages three (3) years old – seven (7) years of age. LPA observed were two attached swings and a slide. LPA observed area around slide has cushioning material to absorb falls. The front yard and Northeast side yard are accessible to the children. LPA confirmed that the new facility sketch provided to LPA ensure the accuracy of the areas being used; the back yard remains off limits to children in care and the front yard and Northeast side yard is used for outside play. The front yard is fenced, and Licensee confirmed that supervision is provided 100 percent of the time the children are outside. LPA observed the new play equipment and ensured that the play structure was anchored to the ground and verified that the water table must be emptied after every use.

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

A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE: DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/11/2024
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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