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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103900433
Report Date: 12/18/2020
Date Signed: 12/18/2020 12:46:26 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:JACKSON,SUZETTEFACILITY NUMBER:
103900433
ADMINISTRATOR:JACKSON,SUZETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 708-8700
CITY:FRESNOSTATE: CAZIP CODE:
93726
CAPACITY:14CENSUS: 3DATE:
12/18/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Suzette JacksonTIME COMPLETED:
12:45 PM
NARRATIVE
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LPA Brannon conducted a case management inspection. LPA met with licensee, Suzette Jackson. During today’s inspection, LPA observed three children with licensee.

During today’s inspection, LPA spoke with licensee regarding the playroom and facility sketch licensee provided when she applied for a Family Child Care Home license. LPA observed that the facility sketch lists a ‘covered patio’ where the children’s playroom is located. Per licensee, the covered patio was converted to an enclosed children’s playroom.

LPA requested a copy of the permit for the enclosed area. Licensee was unable to produce the cleared permit for the converted patio. LPA informed licensee that the children can no longer use the converted patio until the room has been cleared with a permit from the local ordinances. A copy of the permit shall be sent to Fresno Child Care Regional Office no later than 1/18/21. Upon receiving a copy of permit that states the area meets building code standards, a visit from an LPA will be conducted to inspect the children’s playroom. LPA reviewed with licensee what is required and understood that day care children are not to be allowed into the children’s playroom until receipt of permit and inspection by Community Care Licensing.

Type A deficiency was cited. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.



An exit interview was conducted with licensee, Suzette Jackson. A Notice of Site Visit was posted on parent board.

To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2020
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: JACKSON,SUZETTE
FACILITY NUMBER: 103900433
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/18/2020
Section Cited

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Operation of a Family Child Care Home. Pool gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. During today's inspection, LPA observed three children in care. LPA and licensee observed that the pool gate would not self-latch as required.
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This requirement was not meet as evidenced by the pool gate would not self-latch at the varied opening positions. This an immediate risk to the personal rights, health and safety of children in care. An immediate civil penalty of $500 with $100 per day until gate meets Title 22 requirements.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:
DATE: 12/18/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/18/2020
LIC809 (FAS) - (06/04)
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