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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 240406741
Report Date: 09/14/2022
Date Signed: 09/14/2022 08:30:00 AM

Document Has Been Signed on 09/14/2022 08:30 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:GALEN CLARK PRESCHOOLFACILITY NUMBER:
240406741
ADMINISTRATOR:HICKS, MARIEFACILITY TYPE:
850
ADDRESS:211 E 11TH STTELEPHONE:
(209) 385-6619
CITY:MERCEDSTATE: CAZIP CODE:
95341
CAPACITY: 84TOTAL ENROLLED CHILDREN: 84CENSUS: 0DATE:
09/14/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Marie HicksTIME COMPLETED:
09:00 AM
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On September 14, 2022, Licensing Program Analyst (LPA) Cynthia Brannon conducted an announced Case Management inspection and met with Director, Marie Hicks. LPA reviewed the purpose of today's inspection. LPA toured inside and outside areas.

Previous inspection conducted on September 2, 2022. During this inspection, several items were to be corrected. During today's inspection, LPA verified items listed on September 2, 2022 were corrected.

Pending a final file review and completion of above items, a recommendation will be made to license the above facility for the requested capacity of 64 preschool children.

Exit interview conducted and report was reviewed with Director, Marie Hicks.

This report shall be made available to the public upon request. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE: DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/14/2022
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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