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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910199
Report Date: 10/08/2021
Date Signed: 10/08/2021 10:05:56 AM

Document Has Been Signed on 10/08/2021 10:05 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:GARDNER, ASHLYNN FAMILY CHILD CAREFACILITY NUMBER:
153910199
ADMINISTRATOR:GARDNER, ASHLYNNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 477-5036
CITY:SHAFTERSTATE: CAZIP CODE:
93263
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
10/08/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Ashlynn Gardner - Licensee TIME COMPLETED:
10:00 AM
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On 10/8/21 an unannounced Case Management - Plan of Correction (POC) Inspection was conducted by Licensing Program Analyst (LPA) Jessika Thompson. LPA met with Licensee Ashlynn Gardner to discuss the POC associated to the deficiency cited on 7/28/21.

Today, LPA inspected the Licensee's pool area; LPA observed that the swimming pool's fencing is in compliance with Title 22 regulations. The pool fence is at least five feet high and surrounds the body of water. The pool has two entry gates that are both self-latching, self-closing, and open away from the swimming pool. The window that previously provided direct access to the pool area now contains a fixed in place, non-removable window shield. Additionally, there are no gaps in the fencing that exceed regulatory requirements.

LPA provided Licensee with a "Letter of Deficiency Citations Cleared." LPA advised Licensee that this letter must be filed in the facility for three years and upon request made accessible to the public for review.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, no deficiencies were observed today.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Jessika Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 10/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2021
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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