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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503911422
Report Date: 08/11/2021
Date Signed: 08/11/2021 01:52:09 PM

Document Has Been Signed on 08/11/2021 01:52 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:PADILLA, LORENA FAMILY CHILD CAREFACILITY NUMBER:
503911422
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
08/11/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Lorena PadillaTIME COMPLETED:
02:00 PM
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On August 11, 2021 Licensing Program Analysts (LPAs) Kari McWilliams and Robert Gutierrez conducted an unannounced case management visit per Licensee's request regarding the approval to use the upstairs master bedroom as a napping area for infants. LPAs toured the facility and a census was taken. LPAs informed Licensee that the space was not approved due to protect the health and safety of children in care. Licensee is only permitted to use the downstairs approved rooms of bathroom and day care area. The two bedrooms downstairs remain off limits.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Kari McWilliams
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2021
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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