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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103909806
Report Date: 01/10/2020
Date Signed: 01/10/2020 10:26:14 AM

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:RODRIGUEZ, ANDREA FAMILY CHILD CAREFACILITY NUMBER:
103909806
ADMINISTRATOR:RODRIGUEZ, ANDREAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 399-6160
CITY:SANGERSTATE: CAZIP CODE:
93657
CAPACITY:14CENSUS: 0DATE:
01/10/2020
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Andrea RodriguezTIME COMPLETED:
10:30 AM
NARRATIVE
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An informal office meeting was conducted on 01/10/2020 at 09:30am at the Fresno Regional Child Care Office. In attendance at the meeting were Licensee, Andrea Rodriguez, Licensing Program Manager (LPM), Susie Fanning, and Licensing Program Analyst (LPA), Rene Mancinas. The purpose of this meeting was to discuss a recent incident that occurred on 12/19/2019 at facility while LPA Rene Mancinas was conducting an annual inspection, which resulted in violations of California Health and Safety Codes (HS) and California Code of Regulations (CCR) pertaining to the operation of licensed family child care homes.

During annual inspection conducted on 12/19/2019, Licensee provided a false census when asked by LPA how many children were present at the facility. LPA later discovered children in an upstairs area of the home, which is listed as "off limits" and was not approved by the Department as an area to be used for providing care and supervision. When questioned by LPA, Licensee stated the children were upstairs because she believed she was out of ratio. As a result, LPA issued the following deficiencies;

California Health & Safety Code


Conduct inimical
Section 1596.885(c)
Type A

California Code of Regulations Title 22 Division 12 Chapter 3
Utilizing “off limits” area
Section 102416.3(a)(6)
Type B

(Continued on 809-C)

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2020
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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: RODRIGUEZ, ANDREA FAMILY CHILD CARE
FACILITY NUMBER: 103909806
VISIT DATE: 01/10/2020
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During today's meeting the above incident was discussed. Licensee provided a written statement, in which she ensures similar incidents will not result in the future.

Licensee is aware that she is to ensure that she remains in compliance with California Health & Safety Codes and California Title 22 Regulations pertaining to licensed family child care homes.

It was discussed that continued violation(s) of California Health and Safety Codes and California Code of Regulation may result in a Non-Compliance meeting and may be referred to the Department’s Legal Division for possible Administrative Action. A copy of this signed report was given to Licensee, Andrea Rodriguez.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2020
LIC809 (FAS) - (06/04)
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