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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543810129
Report Date: 06/16/2021
Date Signed: 06/16/2021 10:37:57 AM

Document Has Been Signed on 06/16/2021 10:37 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:BOINGOS ACADEMY PHIT CLUBFACILITY NUMBER:
543810129
ADMINISTRATOR:CEBALLOS, ALYSSAFACILITY TYPE:
840
ADDRESS:7131 W PERSHING CTTELEPHONE:
(559) 623-9206
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 45TOTAL ENROLLED CHILDREN: 0CENSUS: 36DATE:
06/16/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Alyssa CeballosTIME COMPLETED:
10:50 AM
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On 06/16/2021, Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced case management inspection and met with Owner, Alyssa Ceballos. LPA explained the reason of the inspection and a tour of the center was conducted both inside and outside. Alyssa requested LPA to come out and remeasure the center to see what her maximum capacity could be since she is wanting to add a gate and take down walls. LPA remeasured the inside of the center and went through the measurements with Alyssa. Alyssa stated that she would remove some walls down, add a sink, and a gate to separate the jungle gym with the inside play area.

Alyssa stated that she is almost done with all the corrections that were requested during the prelicensing inspection. LPA notified Alyssa to notify CCL once she has completed them since another inspection will be required before she can get licensed.

No deficiencies cited during today's visit.


A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Juvenal Moctezuma
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2021
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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