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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547206782
Report Date: 02/26/2024
Date Signed: 02/26/2024 12:32:11 PM

Document Has Been Signed on 02/26/2024 12:32 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:EMPLOY AMERICAFACILITY NUMBER:
547206782
ADMINISTRATOR:DANIELLE, BELTRANFACILITY TYPE:
775
ADDRESS:340 N. FOURTH STTELEPHONE:
(559) 443-7119
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 90CENSUS: 44DATE:
02/26/2024
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:36 AM
MET WITH:Stephanie RamirezTIME COMPLETED:
12:52 PM
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-Today, Licensing Program Analyst L. Xiong arrived at the facility unannounced to conduct the Annual Inspection. LPA met with Program Director Stephanie Ramirez and inform her the purpose of the visit.

Staff and client records reviewed. LPA toured the facility with staff. Facility appeared clean with no obstruction or fire clearance issues. All common areas have adequate seating and lighting. LPA toured classrooms/activity rooms, rooms observed to have all required accommodations.

Smoke detector and carbon monoxide detectors observed operational during inspection. Fire extinguisher present with a service date of 03/2023. Water temperature observed to measure at 105 degrees F.

No deficiencies were observed.
SUPERVISORS NAME: Sergiy Pidgirny
LICENSING EVALUATOR NAME: Les Xiong
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2024
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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