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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543906047
Report Date: 04/14/2023
Date Signed: 04/27/2023 10:18:53 AM

Document Has Been Signed on 04/27/2023 10:18 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:VELAZQUEZ, MARIA DEL FAMILY CHILD CAREFACILITY NUMBER:
543906047
ADMINISTRATOR:VELAZQUEZ, MARIA DELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 740-8209
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
04/14/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Maria Del Carmen Velazquez TIME COMPLETED:
10:30 AM
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On April 27, 2023 Licensing Program Analysts (LPAs) Kari McWilliams and Paul Garcia conducted an unannounced plan of correction inspection and met with Licensee Maria Del Carmen Velazquez. A tour of the facility was conducted and a census was taken.

During today's visit, LPAs reviewed deficiencies cited on prior visit, December 12, 2022. LPAs also followed up on the uncleared adult that was cited on November 7, 2022.

Licensee provided a staff file that was complete for staff #1 (S1).

Licensee also confirmed that the uncleared adult has not returned to the home; they were re-fingerprinted in January 2023 and still pending. LPA advised Licensee to follow up with Guardian.


Per California Code of Regulations Title 22, Division 12, Chapter 3 there are no deficiencies cited during todays inspection. A Notice of Site Visit is provided and must be posted for 30 days.

Exit interview conducted with Licensee Maria Del Carmen Velazquez.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kari McWilliams
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2023
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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