Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203806650
Report Date: 06/08/2016
Date Signed 06/08/2016 01:39:26 PM

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:URIBE, EVA FAMILY CHILD CAREFACILITY NUMBER:
203806650
ADMINISTRATOR:URIBE, EVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 664-0747
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: DATE:
06/08/2016
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Eva UribeTIME COMPLETED:
03:00 PM
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Case Management Visit conducted today by Licensing Program Analyst Rusty Wilson for a child welfare check. Madera Police Department Cross Report was received at the Licensing Office on 5/24/16. Report described an incident where a day care child received scratches from another day care child at the facility. Licensee was interviewed and said that the parent was notified at the time of pickup of the incident. Licensee witnessed the incident but was not able to intervene in time. Licensee said parent seemed to understand at the time and said that lately this child has been doing that a lot. It wasn't until police arrived that the Licensee knew of any problem or misunderstanding. Parent has since apologized for calling the Police and told Licensee that it was just a spur of the moment decision. The children's father also told Licensee he did not understand why she called the police. Licensing Program Analyst toured facility and found all children present in good condition and no signs of any injuries. Children were under direct supervision at the time of this visit.

No deficiencies cited at this visit.
SUPERVISOR'S NAME: Valarie ReedTELEPHONE: (559) 243-8093
LICENSING EVALUATOR NAME: Rusty WilsonTELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2016
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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