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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203902569
Report Date: 07/10/2024
Date Signed: 07/10/2024 10:56:23 AM

Document Has Been Signed on 07/10/2024 10:56 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:GUZMAN, DOLORES FAMILY CHILD CAREFACILITY NUMBER:
203902569
ADMINISTRATOR/
DIRECTOR:		GUZMAN, DOLORESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 675-8279
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/10/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:20 AM
MET WITH:Jennifer Guzman - AssistantTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On 7/10/2024 Licensing Program Analyst (LPA), Stephanie Vega-Gonzalez conducted an announced inspection. LPA introduced herself to Assistant and provided a business card. Licensee was not present in the home during today's visit, but her assistant Jennifer Guzman was present. There were currently no children present in the home. Licensee was called via phone. Licensee stated that she gives LPA permission to conduct the inspection of the newly renovated extended backyard.

LPA inspected the inside and outside of the facility. LPA observed that children will have access to a shaded patio play area through the kitchen/ dinning room area. Patio area is fenced. LPA was led by Assistant to the extended play area. There is a small fence that measures around 3 feet that is between the side shaded patio and the extended play area. LPA observed a play set, a seesaw, large stroller, and other play equipment. LPA observed a treadmill. LPA was informed by Assistant that treadmill will be removed before children are present in the extended back yard/ play area. LPA did not observe any hazards or dangerous objects. Area is fenced. LPA reviewed documents from the City of Madera. Pictures were taken.

As of 7/10/2024, the shaded side patio and extended play yard can be used for children in care.
LPA advised Assistant/ Licensee that children should be supervised at all times especially during transitions and outdoor play.

Exit interview conducted and report was reviewed with Assistant, Jennifer Guzman

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

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. Appeal rights printed and reviewed.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 07/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/10/2024
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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