Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203809807
Report Date: 07/13/2017
Date Signed: 07/13/2017 02:41:41 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:GUERRERO - MENDEZ, ARACELI FAMILY CHILD CARE HOMEFACILITY NUMBER:
203809807
ADMINISTRATOR:GUERRERO - MENDEZ, ARACELIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 673-8040
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 6DATE:
07/13/2017
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Araceli Guerrero-MendezTIME COMPLETED:
02:50 PM
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A Case Management inspection was made at this Family Child Care Home by LPAs Patricia Musso and Kathie Campbell today.
Since licensee only speaks Spanish, she called her daughter to translate this visit in English/Spanish.

Licensee informed LPAs who lives in this home, that she has 6 children enrolled at this time and that her hours of operation are; Mon - Sat 4:00 a.m. - 5:00 p.m..

Licensee gave updated information on a previous request of an exemption.


No Title 22 deficiencies are cited during this visit.

During the exit interview, LPA viewed the LIC9213 being posted and reminded licensee
that it needs to be posted for 30 days.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2017
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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