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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543903627
Report Date: 06/14/2023
Date Signed: 06/14/2023 12:28:30 PM


Document Has Been Signed on 06/14/2023 12:28 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:ROCHA, MARIA FAMILY CHILD CAREFACILITY NUMBER:
543903627
ADMINISTRATOR:ROCHA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 564-8946
CITY:WOODLAKESTATE: CAZIP CODE:
93286
CAPACITY:14CENSUS: 7DATE:
06/14/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Maria RochaTIME COMPLETED:
12:50 PM
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On 6/14/2023, Licensing Program Analyst (LPA) Ruby Ocegueda conducted an unannounced case management inspection. LPA met with Licensee, Maria Rocha. The purpose of this inspection was to conduct a confirmation of removal regarding adult #1. Licensee stated adult #1 does not reside in the home. Licensee understands adult #1 is not allowed to reside in the home and/or be present in the licensed facility. Adult #1 has a child in care and licensee indicated that adult #1 on occasion drops off and picks up the child but will do so only outside of the home and that he/she does not interact with day care children. Licensee indicated that she had not received the Exemption Denial letter before but stated that she had contacted someone at the Care Provider Management Bureau (CPMB) to follow up on the status of adult #1 and they explained that she was not approved to be at the facility, but no further action was necessary. Today, LPA reviewed the Exemption Denial Letter in detail as licensee is Spanish speaking.

Hours of Operation: Monday through Friday; 06:00 am-05:00 pm.

LPA also provided and reviewed with Licensee a copy of the Family Child Care Home Addendum to Notification of Parent's Rights (regarding Removal/Exclusion) form LIC 995B.

Based on the evidence obtained during today's inspection, LPA Ocegueda has verified the individual is not present, employed, or residing at the facility.

Per California Code of Regulations Title 22 Division 12 Chapter 3, no deficiency is being cited today. Notice of Site Visit to be posted for 30 days.

Verification of removal is complete.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2023
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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