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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543810130
Report Date: 03/15/2023
Date Signed: 03/15/2023 10:15:44 AM

Document Has Been Signed on 03/15/2023 10:15 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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:BOINGOS ACADEMYFACILITY NUMBER:
543810130
ADMINISTRATOR:LOIS LOPEZFACILITY TYPE:
850
ADDRESS:7137 W PERSHING CTTELEPHONE:
(559) 623-9206
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 69TOTAL ENROLLED CHILDREN: 69CENSUS: 54DATE:
03/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Alyssa CeballosTIME COMPLETED:
10:30 AM
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 March 15, 2023 Licensing Program Analysts (LPAs) Kari McWilliams and Yesenia Fierro conducted an unannounced case management visit to amend report, LIC 9099 dated 3/6/2023 and met with Licensee Alyssa Ceballos. LPAs toured the facility and a census was taken.

LPAs and Licensee discussed the amended report; report wording was added to explain findings of the complaint. Full wording was included on a LIC 809 collateral visit in lieu of a 9099-C page dated on 3/15/2023. LPA McWilliams and Licensee signed the amended report.

Per Title 22 Division 12 Chapter 1 of the California Code of Regulations there are no deficiencies cited during todays inspection.

Exit interview and report was reviewed with Licensee Alyssa Ceballos.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kari McWilliams
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2023
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 1