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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103903823
Report Date: 08/27/2024
Date Signed: 08/27/2024 10:58:57 AM


Document Has Been Signed on 08/27/2024 10:58 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:OLIVO, CICILY FAMILY CHILD CAREFACILITY NUMBER:
103903823
ADMINISTRATOR:OLIVO, CICILYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 917-8636
CITY:SANGERSTATE: CAZIP CODE:
93657
CAPACITY:14CENSUS: 1DATE:
08/27/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Cicily OlivoTIME COMPLETED:
11:10 AM
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On 8/27/2024 Licensing Program Analyst (LPA) Brandon Tate and Licensing Program Manager (LPM) Juvenal Moctezuma, conducted an unannounced Annual Required Inspection and was met by Licensee, Cicily Olivo. Background criminal record clearances were verified and discussed. All adults living in the home and providing care and supervision to children have a criminal record clearance. Days and hours of operation are 7:30am – 5:30pm, Monday through Friday.

LPA toured the home inside and outside and a census was taken. Current facility sketch was reviewed and Licensee confirmed that the kitchen, bathroom, family room, dining room, and living room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of a child gate and plastic doorknob spinners. There is no swimming pool or other bodies of water on the premises. Licensee was reminded that Firearms and ammunition need to be locked and stored separately. LPA observed guns stored in a gun safe & ammunition stored in a gun case. All poisons are kept in a locked storage area. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

The fireplace located in the family room is made inaccessible by a glass door and will not be in use during daycare hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Stairs are fenced when children under age 5 years old are present. The home has working telephone service and LPA confirmed the phone number is (559) 917-8636.

There are currently no infants in care. LPA discussed Safe Sleep Regulations with Licensee Olivo.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Brandon TateTELEPHONE: (559) 243-4588
LICENSING EVALUATOR SIGNATURE:
DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/27/2024
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 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: OLIVO, CICILY FAMILY CHILD CARE
FACILITY NUMBER: 103903823
VISIT DATE: 08/27/2024
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Licensee has a current roster of the children. An emergency fire/disaster drill has been completed and documented within the last 6 months. Licensee’s Mandated Reporter Training was completed on 11/29/2023. Licensee’s pediatric CPR/First Aid expires on 4/12/2026. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm


Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited. Licensee was provided a copy of appeal rights.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee Olivo was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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

Exit interview conducted and report was reviewed with licensee Cicily Olivo.

SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Brandon TateTELEPHONE: (559) 243-4588
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
LIC809 (FAS) - (06/04)
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