<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203801195
Report Date: 06/05/2025
Date Signed: 06/05/2025 03:00:16 PM

Document Has Been Signed on 06/05/2025 03:00 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CHOWCHILLA HEAD STARTFACILITY NUMBER:
203801195
ADMINISTRATOR/
DIRECTOR:		BRAVO, MARTHAFACILITY TYPE:
850
ADDRESS:265 HOSPITAL DRIVETELEPHONE:
(559) 665-0291
CITY:CHOWCHILLASTATE: CAZIP CODE:
93610
CAPACITY: 40TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/05/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:05 PM
MET WITH:Yareni Pumarejo.TIME VISIT/
INSPECTION COMPLETED:
03:15 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 06/05/2025 Licensing Program Analyst (LPA) Julio Rodriguez conducted a Case Management inspection that was initiated by the licensee. LPA met with Area Manager for Madera Head Start, Yareni Pumarejo. Yareni indicated Chowchilla Head Start falls under the Madera Head Start Organization. LPA observed no children at the center and Yareni indicated that the preschool does not operate from May 28th – to approximately August 11th. LPA conducted a tour of the facility inside and outside. The purpose for the inspection was to inspect the newly added outdoor playground. The outdoor play yard size was not modified. The Department was notified on 05/21/2025 that the playground was ready for an inspection.

The outdoor activity space has a shade canopy over the play structure that provides ample shade for children. The shade canopy has cushioned poles for children safety. The playground will be utilized by children ages ranging 2 to 5 years old. Water is available indoors and outdoors. Yareni indicated water is provided for children by water dispenser.

The new play structure has a manufacturer label that indicates the equipment is designed for children ages 2 to 5 years old which is appropriate for the preschool children. LPA observed adequate cushioning in the form of a rubber surface beneath the play structure and landing of the slides to absorb falls. LPA advised Yareni to have staff conduct frequent safety inspections of the play structure to check for any loose parts, cracks, and hazards. Area Manager Yareni Pumarejo is aware of child safety around the play structure and assumes all responsibility. Yareni Pumarejo understands that children must be supervised at all times while using the play structure. Outdoor activity space surface is maintained in a safe condition and is free of hazards. Yareni Pumarejo has a copy of the user’s manual and will ensure staff members at the facility will follow the manufacturer’s instructions. Continued on 809-C.

NAME OF LICENSING PROGRAM MANAGER: Juvenal Moctezuma
NAME OF LICENSING PROGRAM ANALYST: Julio Rodriguez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CHOWCHILLA HEAD START
FACILITY NUMBER: 203801195
VISIT DATE: 06/05/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Playground equipment is in good condition, free of sharp, loose, or pointed parts. At the end of the inspection, LPA met with Yareni Pumarejo to review the report and conclude the inspection. The outdoor play area has been approved for facility use by preschool children, effective today 06/05/2025.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies are being cited. Area Manager Yareni Pumarejo was provided a copy of appeal rights. A notice of site visit was given and must remain posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Juvenal Moctezuma
NAME OF LICENSING PROGRAM ANALYST: Julio Rodriguez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2025
LIC809 (FAS) - (06/04)
Page: 3 of 3