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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203810221
Report Date: 08/11/2022
Date Signed: 08/11/2022 09:39:16 AM

Document Has Been Signed on 08/11/2022 09:39 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:WASHINGTON STATE PRESCHOOLFACILITY NUMBER:
203810221
ADMINISTRATOR:ADALBERTO HERNANDEZFACILITY TYPE:
850
ADDRESS:509 E SOUTH STTELEPHONE:
(559) 674-6705
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 0DATE:
08/11/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Brenda NaranjoTIME COMPLETED:
09:45 AM
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On August 11, 2022, Licensing Program Analyst (LPA) C Brannon conducted an announced prelicensing inspection and met with Brenda Naranjo, ECE Specialist. Prior prelicensing inspection was conducted on August 8, 2022.

During previous inspection, the following items needed to be corrected. Today's inspection is to verify the corrections required were completed.



1) Anchor three shelving units in classroom P1 has been completed.


Pending a final file review, a recommendation will be made to license the above facility for the requested capacity of 48 preschool children.

Exit interview conducted and report was reviewed with Brenda Naranjo.

A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.


THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022
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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