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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911679
Report Date: 07/01/2024
Date Signed: 07/01/2024 01:17:24 PM

Document Has Been Signed on 07/01/2024 01:17 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
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:AYALA, MARICELA FAMILY CHILD CAREFACILITY NUMBER:
153911679
ADMINISTRATOR/
DIRECTOR:		AYALA, MARICELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 300-0006
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
07/01/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Maricela AyalaTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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On 7/1/2024 Licensing Program Analyst (LPA) Claribel Soto and Licensing Program Manager (LPM) Scott Herring conducted an unannounced Case Management Visit and met with licensee, Maricela Ayala to discuss a discrepancy regarding fingerprint clearances. Licensee provided a document indicating that she is fingerprinted and cleared to the licensed facility as of 07/31/2023. LPA Soto received the copy of the document. Licensee advised LPA Soto and LPM Herring that she will re-fingerprint just as a voluntary courtesy pending the review of the documents provided. Based on the information received, further assessment is needed to make a determination. Licensee will provide proof of fingerprinting to CCL Fresno by 7-2-2024.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Claribel Soto
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2024
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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