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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243910939
Report Date: 09/04/2024
Date Signed: 09/04/2024 11:49:39 AM

Document Has Been Signed on 09/04/2024 11:49 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:INIGUEZ, LILI FAMILY CHILD CAREFACILITY NUMBER:
243910939
ADMINISTRATOR/
DIRECTOR:		INIGUEZ, LILIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 600-9743
CITY:MERCEDSTATE: CAZIP CODE:
95348
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
09/04/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Lili Iniguez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:00 AM
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On 09/04/2024, Licensing Program Analyst (LPA) Ka Vang conducted an unannounced Case Management-Other. LPA met with Licensee Lili Iniguez, who speaks Spanish. Staff #1 provided the Spanish interpretation. LPA toured the facility indoor and outdoor, and census was taken.

During the inspection, LPA explained the purpose of the inspection was to amended a report. The report was amended and reviewed with Licensee during this inspection. Licensee stated that she understood the report.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiency is being cited during today’s inspection.

Licensee was provided a copy of appeal rights. A notice of site visit (LIC 9213) was given and must remain posted for 30 days. This report shall be made available to the public upon request. Exit interview conducted and report was reviewed with Licensee Lili Iniguez.
SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE: DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/04/2024
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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