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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 150407649
Report Date: 06/01/2022
Date Signed: 06/01/2022 09:29:50 AM

Document Has Been Signed on 06/01/2022 09:29 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:ROSE FAMILY DAY CAREFACILITY NUMBER:
150407649
ADMINISTRATOR:ROSE, JUDYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 834-0345
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93313
CAPACITY: 12TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Judy Rose - LicenseeTIME COMPLETED:
09:20 AM
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On 6/01/22, LPA Jessika Thompson conducted an unannounced case management inspection. Initially, the purpose of this visit was to conduct an annual inspection; however, licensee stated she is no longer operating a day-care and wishes to permanently close, thereby terminating her license. Licensee stated that she submitted paperwork to Licensing affirming her closure earlier this month.

LPA discussed exempt care with the licensee. Licensee's child-care home will be closed permanently effective today.

No deficiencies were cited on this date.

SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Jessika Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 06/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/01/2022
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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