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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910361
Report Date: 05/22/2024
Date Signed: 05/22/2024 10:04:11 AM

Document Has Been Signed on 05/22/2024 10:04 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:LOPEZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
543910361
ADMINISTRATOR/
DIRECTOR:		LOPEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 366-7989
CITY:TULARESTATE: CAZIP CODE:
93274
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 3DATE:
05/22/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Maria LopezTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On 05/22/2024 Licensing Program Analyst (LPA), Behatriz Gonzalez conducted a case management visit and was met by licensee Maria Lopez. Also present was licensee’s adult daughter, licensee’s assistant. Days and hours of operation are Monday to Friday 6am to 6pm.

Todays visit was to collect a wet signature for the past annual inspection to file in the facility profile.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Behatriz Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2024
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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