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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808251
Report Date: 05/06/2022
Date Signed: 05/06/2022 03:16:25 PM

Document Has Been Signed on 05/06/2022 03:16 PM - 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:SAN LUIS HEAD STARTFACILITY NUMBER:
243808251
ADMINISTRATOR:FLORES, MELANIEFACILITY TYPE:
850
ADDRESS:129 7TH STREETTELEPHONE:
(209) 827-5691
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 0DATE:
05/06/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Misty MendozaTIME COMPLETED:
03:45 PM
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On May 6, 2022, Licensing Program Analyst (LPA) C Brannon met with Site Supervisor, Misty Mendoza.

On 4/14/22, LPA issued a citation. During today's inspection, LPA observed that the appropriate age sticker is on the climbing structure states the climbing structure is for ages 2 to 12 years old. This is a preschool program for children ages 2 to 6 years old. Licensee, Merced Office of Education, Regional Head Start, is to ensure that staff is near by to provide adequate supervision and to assist the preschool children as needed.

LPA observed that licensee installed a white picket fence around the exposed wiring on the preschool play yard.

LPA observed that licensee had the building exterior wall repaired and painted.

Previous deficiency is cleared during today's inspection. LPA provided Letter of Deficiency Citations Cleared form during today's inspection.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are cited.

Exit interview conducted and report was reviewed with Site Supervisor, Misty Mendoza.

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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Cynthia Brannon
LICENSING EVALUATOR SIGNATURE: DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2022
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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