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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243807228
Report Date: 11/13/2023
Date Signed: 12/01/2023 09:44:28 AM

Document Has Been Signed on 12/01/2023 09:44 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:FLORES, MARTHA FAMILY CHILD CAREFACILITY NUMBER:
243807228
ADMINISTRATOR:FLORES, MARTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 723-1392
CITY:MERCEDSTATE: CAZIP CODE:
95341
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 4DATE:
11/13/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:09 PM
MET WITH:Martha Flores TIME COMPLETED:
12:45 PM
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On November 13,2023, Licensing Program Analyst (LPA) Yesenia Fierro conducted a unannounced case management to verify that Licensee son guns and ammunition are being stored separate. LPA observed ammunition to be stored in ammunition boxes, but they were still inside the safe not separated from the guns. Licensee was advised the guns and ammunition need to be stored separately even if the ammunition is being stored in ammunition box, they need to locked and separate. Licensee stated she understood and will be buying a separate safe to store the ammunition.
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2023
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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