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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103809946
Report Date: 09/03/2025
Date Signed: 09/03/2025 12:24:27 PM

Document Has Been Signed on 09/03/2025 12:24 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:GRAVES, MARCELLA FAMILY CHILD CAREFACILITY NUMBER:
103809946
ADMINISTRATOR/
DIRECTOR:		GRAVES, MARCELLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 494-0744
CITY:FRESNOSTATE: CAZIP CODE:
93728
CAPACITY: 14TOTAL ENROLLED CHILDREN: 25CENSUS: 0DATE:
09/03/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Marcella GravesTIME VISIT/
INSPECTION COMPLETED:
12:40 PM
NARRATIVE
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On September 3, 2025, Licensing Program Analyst (LPA) Miguel Herrera conducted an unannounced case management inspection. LPA met with Licensee Marcella Graves to discuss the case management inspection. A tour of the facility was conducted, and a census was taken.

LPA toured the home inside and a census was taken. During the inspection, LPA Herrera did not observe any children present. Licensee did not have an assistant present during the inspection.

During today's inspection LPA conducted a review of staff and children records. Licensee Graves had a complete Child's Roster (LIC 9040) for all the children enrolled in her care during today's inspection.

However, during records review LPA Herrera was unable to review a file for Licensee Graves' assistant as she stated that she did not have a file for her assistant. Licensee Graves stated that she was going to obtain immunization records and complete licensing forms for her assistant.

Furthermore, LPA Herrera reviewed children files and observed several children with incomplete or missing files. Based on records reviewed Licensee Graves had 6 children files missing and stated that she had misplaced them. Licensee stated that she was going to obtain immunization records and required licensing forms from the children's authorized representatives.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following Type B deficiencies are being cited: (see next page, LIC 809 D). Licensee Marcella Graves was provided with a copy of appeal rights. LIC 9213 Notice of Site visit form was provided to Licensee Marcella Graves and is required to be posted for 30 days. This report shall be made available to the public upon request.

NAME OF LICENSING PROGRAM MANAGER: Jose Penate
NAME OF LICENSING PROGRAM ANALYST: Miguel Herrera
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/03/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 09/03/2025 12:24 PM - It Cannot Be Edited


Created By: Miguel Herrera On 09/03/2025 at 11:45 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: GRAVES, MARCELLA FAMILY CHILD CARE
FACILITY NUMBER: 103809946

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2025
Section Cited
CCR
102421(b)

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(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required
in Section 102417(g)(7).
This requirement is not met as evidenced by:
The licensee did not comply with the section cited above in that, during record...
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Licensee stated that she will complete a facility file for all children missing records and will update all other files missing immunization records. Licensee Graves stated that she will submit the updated records to CCL by POC due date, 09/17/2025.
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review LPA did not observe a facility file for Child's Records for Child #1 and Child #2, Child #3, Child #4, Child #5, and Child #6's. Additionally, some chidlren files were incomplete which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
09/17/2025
Section Cited
CCR102416.1(d)

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Based on record review, the licensee did not comply with the section cited above in that Licensee did not have a file with required licensing documents for Assistant which poses a potential health, safety, or personal rights risk to persons in care.
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Licensee agreed that she will complete Assistant's file with required licensing documents and provide proof to CCL - Fresno by 09/17/2025.

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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.
Jose Penate
NAME OF LICENSING PROGRAM MANAGER:
Miguel Herrera
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/03/2025


LIC809 (FAS) - (06/04)
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