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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153803286
Report Date: 03/17/2022
Date Signed: 03/17/2022 03:06:15 PM

Document Has Been Signed on 03/17/2022 03:06 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:HERNANDEZ FAMILY CHILD CAREFACILITY NUMBER:
153803286
ADMINISTRATOR:HERNANDEZ, SOLEDADFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 454-6120
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
03/17/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:HERNANDEZ, SOLEDADTIME COMPLETED:
03:30 PM
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On 3/17/2022, Licensing Program Analysts (LPAs), Gloria Reyes and Roman Iglesias, conducted an unannounced Case Management inspection to determine if Licensee is caring for children or if she wants to go on inactive status. LPAs met with licensee and informed her of the reason of the visit. Licensee stated she has not been caring for children since November 2021, due to being hospitalize as of result of COVID-19. Licensee was caring for a child, who she stated that it was her grandson.

On this day, Licensee stated she was unsure if she will be opening in April or May 2022 but could be longer than that. Therefore, Licensee signed the "Request for Inactive Child Care License Status" form, in that she is requesting on this day to go inactive. Licensee understands that prior to opening her day-care, she needs to contact LPA Reyes to inform her that she will be opening. Additionally, Licensee understands that prior to opening she will make sure all children's files/ her files are current and areas accessible to children need to meet regulation.

Per California Code of Regulations Title 22, Division 12, Chapter 1, no deficiency is cited today.

Notice of Site Inspection to be posted for 30 days.

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Roman Iglesias
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2022
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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