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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543911284
Report Date: 01/11/2023
Date Signed: 01/11/2023 11:00:21 AM

Document Has Been Signed on 01/11/2023 11:00 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:SUGAI, VINCENTA FAMILY CHILD CAREFACILITY NUMBER:
543911284
ADMINISTRATOR:SUGAI, VINCENTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 960-3774
CITY:DINUBASTATE: CAZIP CODE:
93618
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
01/11/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Vincenta SugaiTIME COMPLETED:
11:15 AM
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On 1/11/23, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced case management inspection. The purpose of the inspection was to amend the previous Facility Evaluation Report dated 6/9/22 regarding an annual inspection that was conducted. The previous report (dated 6/9/22) was amended because it incorrectly stated there were firearms on the premises. The report should have stated there were no firearms on the premises.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations no deficiencies were observed today.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Vincenta Sugai.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kathy Pacheco
LICENSING EVALUATOR SIGNATURE: DATE: 01/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/11/2023
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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