Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103909306
Report Date: 05/28/2015 12:00:00 AM
Date Signed 05/28/2015 10:51:35 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 E.SHAW AV,STE 300-MS 29-01
FRESNO, CA 93710
FACILITY NAME:BURCHELL, JULIE FAMILY CHILD CAREFACILITY NUMBER:
103909306
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
05/28/2015
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Julie BurchellTIME COMPLETED:
11:00 AM
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An unannounced Case Management Visit is being conducted today by Licensing Program Analyst Patricia Musso.

This Case Management visit is being conducted for the assigned LPA, Musso, to introduce herself
to licensee and see if licensee had any questions since being licensed at this home.
Licensee had a couple of questions regarding her increasing her license to a Large Family Day Care (which she has already submitted her application to CCL, had the fire department inspect her home, and has paperwork in to the city of Fresno for her city permit). LPA went over the capacity
of having a large license, children count on her census when they are here, when her assistants need to/can help, and how/when licensee can go on vacation and her assistants caring for the children.
Licensee is using door knob spinners on her off limit rooms.
LPA advised licensee to have stickers or decals on her sliding glass door that leads to the back
yard.
Licensee's small dog is kept separate from the day care children but licensee is informed that she is responsible for any action of the dog and could result in the lose of the day care license.

During the exit interview, LPA gave instructions to post LIC9213 for 30 days, which was left with licensee today.

No Title 22 deficiencies are cited during this visit.
Hours of operation are Monday through Friday, 7:30 am to 5:30 pm.
SUPERVISOR'S NAME: Valarie ReedTELEPHONE: (559) 243-8093
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2015
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2015
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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