<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103909421
Report Date: 02/14/2023
Date Signed: 02/14/2023 10:56:53 AM


Document Has Been Signed on 02/14/2023 10:56 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, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:VALENZUELA, JAMIE FAMILY CHILD CAREFACILITY NUMBER:
103909421
ADMINISTRATOR:VALENZUELA, JAMIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 473-3685
CITY:FRESNOSTATE: CAZIP CODE:
93726
CAPACITY:14CENSUS: 10DATE:
02/14/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Jamie ValenzuelaTIME COMPLETED:
10:25 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 02/14/2023, Licensing Program Analyst (LPA) Denisia Jimenez and Licensing Program Managers (LPMs) Juvenal Moctezuma and Cynthia Brannon conducted an unannounced case management inspection. LPA met with Licensee, Jamie Valenzuela and discussed the purpose of the inspection. A Tour of the home was conducted and census were taken.

Upon arrival LPM Brannon observed child #2, who is five months old, asleep in a swing with a blanket. LPM Brannon went to the sleeping infant. The sleeping infant was covered with a blanket, which held a propped bottle. LPM Brannon removed the bottle and blanket. During today's inspection, LPM Brannon reviewed with licensee that infants are to be held while feeding the infant with a bottle, a blanket cannot cover a sleeping infant, and the sleeping infant is to be removed from the swing and placed in a crib when the infant falls asleep. When brought to licensee's attention, Jaime Valenzuela removed sleeping infant from swing and placed infant in a pack-n-play.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, this deficiency is being cited on the attached LIC 809D. A type A citation was issued during today's inspection.

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." The licensee was provided a copy of the "Fact Sheet" for AB 633 (Parent Notification Requirements), along with a copy of the relevant documents this date. A completed signed copy of the LIC 9224 will be placed in each child's file.

An exit interview conducted with licensee, Jamie Valenzuela. A copy of this report and Appeal Rights were provided and discussed with licensee, Jamie Valenzuela.
A Notice of Site Visit Form was posted to parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia JimenezTELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2023
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


Document Has Been Signed on 02/14/2023 10:56 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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


FACILITY NAME: VALENZUELA, JAMIE FAMILY CHILD CARE
FACILITY NUMBER: 103909421

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/21/2023
Section Cited

1
2
3
4
5
6
7
Infant Safe Sleep. An infant’s head shall not be covered while sleeping. This requirement was not met as evidenced by LPM's observance of a sleeping infant in a swing, with blanket and propped bottle. This is an immediate personal rights, health and safety to children in care.
1
2
3
4
5
6
7
After LPM informed licensee of safe sleep regulations, licensee removed baby from swing and placed sleeping infant in the pack-n-play. Per licensee, she will provide a written protocol when feeding infants and placing a sleeping infant in a crib or pack-n-play. This written protocol shall be sent to
8
9
10
11
12
13
14
8
9
10
11
12
13
14
the Fresno Community Care Licensing office by 2/21/2023.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia JimenezTELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:
DATE: 02/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/14/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2