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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503608001
Report Date: 07/18/2024
Date Signed: 07/18/2024 12:00:41 PM

Document Has Been Signed on 07/18/2024 12:00 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:COLLINS, DENISEFACILITY NUMBER:
503608001
ADMINISTRATOR/
DIRECTOR:		COLLINS, DENISEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 577-1627
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
07/18/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Denise CollinsTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 07/18/2024, an unannounced Case Management inspection, which was initiated by the Licensee, was conducted today by Licensing Program Analyst (LPA), Valerie Mireles. LPA met with Licensee, Denise Collins. There were three children in care at the time of the inspection. The purpose of this inspection was to discuss the inaccessible office, two guest bedrooms, and guest bathroom in the home, as the licensee intends to revise her facility floor plan, making the inaccessible office, guest bedrooms and guest bathroom ACCESSIBLE moving forward. Licensee intends on using these rooms primarily during nap time or when a child displays symptoms of illness. Licensee provided an updated LIC999 Floor Plan.

Hours or operation remain Monday through Friday 7:30 AM – 5:00 PM.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiency is being cited during today's visit. Report was reviewed with Denise Collins. LIC 9213 Notice Of Site visit form was provided to Licensee and is required to be posted for 30 days. This report shall be made available to the public upon request.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2024
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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