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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 547208780
Report Date: 01/08/2025
Date Signed: 01/09/2025 09:12:21 AM

Document Has Been Signed on 01/09/2025 09:12 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
CCLD Regional Office, 1314 E SHAW AVE
FRESNO, CA 93710
FACILITY NAME:AMBITIONS - MAE CARDENFACILITY NUMBER:
547208780
ADMINISTRATOR/
DIRECTOR:		MATA, JESSICAFACILITY TYPE:
735
ADDRESS:2126 N MAE CARDEN CTTELEPHONE:
(559) 739-7975
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 4CENSUS: 3DATE:
01/08/2025
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Jessica Mata, Administrator TIME VISIT/
INSPECTION COMPLETED:
05:05 PM
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On 01/08/2025, licensing Program Analyst L. Salazar returned to the facility unannounced to conduct a Plan of correction (POC) visit LPA was greeted by Administrator, stated the purpose of the visit and was allowed entry into the facility.

LPA received the plan of correction for the deficiencies issued on 01/08/25 for complaint #24-AS-20241017090403. POC letter was generated and provided to Administrator.

Due to time and circumstances, LPA was unable to review the 01/07/25 case management reports with Administrator the day of the visit. Reports have been reviewed with Administrator with POC dates 01/09/25 discussed.

Exit interview conducted.
SUPERVISORS NAME: Melinda Hoffmann
LICENSING EVALUATOR NAME: Lisa Salazar
LICENSING EVALUATOR SIGNATURE: DATE: 01/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/08/2025
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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