Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153903235
Report Date: 03/30/2016
Date Signed: 03/30/2016 09:46:21 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 E.SHAW AV,STE 300-MS 29-01
FRESNO, CA 93710
FACILITY NAME:TINOCO, TRINDAD FAMILY CHILD CAREFACILITY NUMBER:
153903235
ADMINISTRATOR:TINOCO, TRINIDADFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 854-1723
CITY:ARVINSTATE: CAZIP CODE:
93203
CAPACITY:14CENSUS: 5DATE:
03/30/2016
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Trinidad Tinoco, LicenseeTIME COMPLETED:
10:00 AM
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LPA Pete Espinoza conducted Case Management visit today. LPA met with Trinidad Tinoco, Licensee, who provided a tour of the home, inside and outside, as shown on the facility sketch. Purpose of the visit was to discuss recent garage conversion for day-care use. LPA observed converted garage that contains separate entrance, heating and cooling systems and exit to play yard. Licensee provided copy of completed Inspection Record Card signed by City of Arvin Building Department.

Licensee will send to Fresno Regional Office updated Facility Sketch designating areas of use by day-care children and areas that are "off-limits" and inaccessible to day-care children.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2016
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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