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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910265
Report Date: 02/06/2023
Date Signed: 02/06/2023 01:56:36 PM


Document Has Been Signed on 02/06/2023 01:56 PM - 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:CORREA, CHERILYN FAMILY CHILD CAREFACILITY NUMBER:
543910265
ADMINISTRATOR:CORREA, CHERILYNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 280-5184
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 11DATE:
02/06/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Savanna CorreaTIME COMPLETED:
02:15 PM
NARRATIVE
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On February 6, 2023 Licensing Program Analyst (LPA) Kari McWilliams conducted an unannounced case management inspection and met with Licensee's adult daughter; Savanna Correa. Ms. Correa shared that Licensee was on her way home from out of town. LPA toured the facility and a census was taken.

LPA McWilliams provided the reason why she was here to Ms.Correa and though she had information regarding the incident Ms. Correa felt it would be better to call Licensee Cherilyn Correa.

LPA McWilliams spoke to Licensee Cherilyn Correa over the phone regarding information that her husband had been arrested. Licensee confirmed that in September 2022 there was an incident where her husband was arrested and has since been living outside of the home. Licensee confirmed that the incident did not happen at home and there were no children present. Licensee confirmed that she is aware that her husband cannot be around children in care until he has applied and received an exception from the Department. Further information documented on 812. Licensee acknowledged that the incident happened prior to the annual inspection conducted on 12/7/2022; and that she was not emotionally able to handle talking about the incident when she was working.

LPA McWilliams informed Licensee of the reporting requirements in a family child care home and provided Licensee with a copy of the regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

Exit interview was conducted with Licensee over the phone and Licensee gave permission for Ms. Correa to sign the report. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISOR'S NAME: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2023
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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Document Has Been Signed on 02/06/2023 01:56 PM - 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: CORREA, CHERILYN FAMILY CHILD CARE
FACILITY NUMBER: 543910265

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/06/2023
Section Cited

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(a) The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm).(2) Any change in household composition including adults moving in or out of the home and anyone living in the home who reaches his or her 18th birthday.
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LPA provided Licensee with a copy of the reporting requirement and Licensee stated that she understood the importance of reporting and transperancy.
Licensee states that she understands her husband is not allowed in the home until he receives an exception, if he receives an exception.
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This requirment was not met by interview in which Licensee confirmed that her husband was arrested and no longer living in the home; which poses a potential health safety or personal rights violation to children in care.
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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: Luisa GavoutianTELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Kari McWilliamsTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2023
LIC809 (FAS) - (06/04)
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