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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503810140
Report Date: 03/29/2022
Date Signed: 03/29/2022 01:48:15 PM

Document Has Been Signed on 03/29/2022 01:48 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:JUST KID'N AROUND CHILDCAREFACILITY NUMBER:
503810140
ADMINISTRATOR:BISHOP, LAURAFACILITY TYPE:
850
ADDRESS:4718 BROADWAY AVETELEPHONE:
(209) 869-5900
CITY:SALIDASTATE: CAZIP CODE:
95368
CAPACITY: 38TOTAL ENROLLED CHILDREN: 38CENSUS: 0DATE:
03/29/2022
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:PERSHALL, MELISSATIME COMPLETED:
01:30 PM
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On 03/29/2022, a video Zoom meeting was conducted. Those in attendance included Licensing Program Manager (LPM), Alice Juarez, Licensing Program Analyst (LPA), Roman Iglesias, and Licensee, Melissa Pershall. The purpose of this meeting was to discuss recent violations of Title 22 Regulations.

February 23, 2022--Complaint investigation visit conducted by LPA Iglesias

Deficiency Citations: Type B: 101214(a) Accountability

During this meeting, it was discussed that violation of Title 22 Regulations and failure to maintain compliance will result in an Informal conference and the licensee may be referred to the Legal Division for possible Administrative action.

A copy of this report was mailed to Licensee, Melissa Pershall. No deficiencies were cited during today’s meeting.

SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Roman Iglesias
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2022
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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