163903188-11-17-2022-57-CC-DMEO-CL9QGS-20221117111001

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 163903188
Report Date: 11/17/2022
Date Signed: 11/17/2022 11:10:06 AM

Document Has Been Signed on 11/17/2022 11:10 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	PULIDO, ALEJANDRA FAMILY CHILD CARE		FACILITY NUMBER:	163903188
ADMINISTRATOR:	PULIDO, ALEJANDRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 386-2965
CITY:	AVENAL	STATE: CA	ZIP CODE:	93204
CAPACITY:	14	CENSUS: 3	DATE:	11/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Alejandra Pulido		TIME COMPLETED:	11:30 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 11/17/2022 Licensing Program Analyst (LPA) Diane Mercado, conducted an unannounced Annual Required Inspection and was met by Licensee, Alejandra Pulido. Licensee is Spanish Speaking and LPA Mercado assisted with interpretation. Background criminal record clearances are verified and discussed, and LIS 531 is signed indicating that the adults living in the home and/or providing care and supervision to children have a criminal record clearance. Days and hours of operation are Monday-Saturday 4am-5pm. LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed, and Licensee confirmed that the living room, dining room, kitchen and hallway bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of plastic door spinners. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection.Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559) 386-2965. There are currently no infants in care. LPA discussed Safe Sleep Regulations with licensee. 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. Continued 809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Diane Mercado	TELEPHONE: 559-341-6334
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PULIDO, ALEJANDRA FAMILY CHILD CARE	FACILITY NUMBER: 163903188
	VISIT DATE: 11/17/2022

NARRATIVE

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LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was completed on 12/07/2023. Licensee’s pediatric CPR/First Aid expires on 09/17/2024. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles. 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.

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 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.

Continued 809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Diane Mercado	TELEPHONE: 559-341-6334
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PULIDO, ALEJANDRA FAMILY CHILD CARE	FACILITY NUMBER: 163903188
	VISIT DATE: 11/17/2022

NARRATIVE

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LPA discussed the safe sleep regulations with licensee 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 the licensee.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Diane Mercado	TELEPHONE: 559-341-6334
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

LIC809 (FAS) - (06/04)

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