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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810184
Report Date: 02/24/2022
Date Signed: 03/08/2022 03:10:31 PM

Document Has Been Signed on 03/08/2022 03:10 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:H.O.M.E. L.L.C.FACILITY NUMBER:
103810184
ADMINISTRATOR:ASHLEY MATOTTFACILITY TYPE:
840
ADDRESS:1525 FULTON STTELEPHONE:
(559) 301-2193
CITY:FRESNOSTATE: CAZIP CODE:
93721
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/24/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jaeda AblesTIME COMPLETED:
12:45 PM
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On 02/24/2022, Licensing Program Analysts (LPAs) Juvenal Moctezuma & Joseph Pacheco conducted an announced Prelicensing inspection and met with Owner, Jaeda Ables & Site Supervisor, Ashley Matott. LPAs explained the reason of the inspection and a tour of the center was conducted both inside and outside. The center is located on the premises of Cornerstone Church (Cornerstone Conference Center) on 1537 Fulton St in Fresno, CA & not 1525 Fulton St as the application states. Applicant is requesting a School Age License of 60 School Age children. This program will operate year round from 6:15 AM to 5:45 PM Monday through Friday. This program plans to operate in 3 classrooms on the first floor (101-103) & 2 classrooms upstairs (202 & 205).

Breakfast, lunch, & a PM snack will be provided by the Fresno Economic Opportunity Commission and Food to Share Program. Food will be brought over in warmers (containers) and disbursed to each classroom where children will eat. Applicant has a fridge and cabinets in the break room/Storage where snacks will be prepared and stored if needed. There is a fridge and a portable Sink which will have hot water. Parents are allowed to bring their child lunch if they wish. Applicant stated they will get a microwave in case food needs to be warmed up. The cleaning supplies will be stored in the Laundry Room area which will be inaccessible to children in care. Staff will utilize 2 staff bathrooms located next to the children's bathroom. Ill children will be isolated in the Break Room and will use one of the staff bathrooms when ill.

The school age classrooms were observed to be clean and free of toxins. LPAs observed that the furniture and equipment appeared to be safe and in good condition. LPA reminded applicant to not store anything on top of the children's cubbies or tall bookcases that could potentially fall on the children. Jaeda understood. Jaeda will submit proof of a working carbon monoxide inside the center. She also stated that there will be a sanitation station at the front entrance where staff will do wellness checks every morning during drop off and take the children's and staffs temperatures every morning. Masks are worn by staff and children while indoors which are provided by the facility in case parent forgets.

Report Continued Onto LIC 809-C

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Juvenal Moctezuma
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2022
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 4
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: H.O.M.E. L.L.C.
FACILITY NUMBER: 103810184
VISIT DATE: 02/24/2022
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Room measurements were taken and reviewed with Jaeda. The total inside school age area measured to an approximate 2,867 square feet which will accommodate 60 School Age children. There is adequate storage space available for children's belongings in each area. There are enough tables, chairs, & toys for children to play with. Toys and equipment appear to be age appropriate. There are a total of 2 toilets, 2 Urinals, & 3 sinks in the boys bathroom & 4 Toilets & 3 Sinks in the girls bathroom which will accommodate the requested capacity of 60 School Age children. Jaeda stated that there will be a water dispenser in each classroom so children can have water readily available to them at all times. Applicant will use a water jug outside with cup dispensers for water usage. Children will be brought in the the building to use the chidlrens bathroom.

The approximate outside square footage for the Play Area is 3,630 which will only accommodate 48 school age children at a time. Applicant stated that she will stagger her play times and submit a waiver which will be pending approval. The play area has a mesh see through fence to make the water fountain inaccessible. The self latching gate is not working properly. The whole area has a permanent shade structure and bushes that will need to be maintained. There are a couple of rose bushes which jaeda stated will make inaccessible to children in care by adding a gate around them. Another gate will be added so children don't have access to the trash area. Jaeda stated that she will piurchase toys as the center opens. The Play area is gated all around. Jaeda stated that the church owns the entire building but that play area has a separate address than the potentially licensed address (school age area). LPA notified Jaeda that LPA will speak with management in regards to the play area and see if that will be allowed to use for the school age license.

A fire clearance for 60 School age children was received and granted by the Fresno Fire Department on 12/23/2021. An Amended Fire Clearance will be submitted to the fire department to show that both address have a clearance.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

Jaeda was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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 Child Care Center. 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.

Report Continued Onto LIC 809-C

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Juvenal Moctezuma
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: H.O.M.E. L.L.C.
FACILITY NUMBER: 103810184
VISIT DATE: 02/24/2022
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LPA discussed the safe sleep regulations with Applicant 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 Applicant 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.

The following items must be completed prior to issuing a license by 03/14/2022.


Classroom Area
  • Cabinets be removed as stated by Jaeda from all classrooms.
  • Get working carbon monoxide.
  • Anchor Cubbies and any other large furniture to prevent from tipping over in all classrooms.
  • Latch/lock water heater closet in all classrooms.
  • Outlet Covers for all classrooms.
  • Tv Cable exposed - make inaccessible in room 102
  • water dispenser & Cup dispensor as stated by Jaeda will be placed in every classroom.
  • Classroom 103 needs cubby space or hooks for children to place belongings.
Physical Plant:
  • Lock hall cabinet near staff bathroom
  • Toilet seat cover in boys bathroom is broken
  • Fix Boys sink in bathroom
  • Remove plungers and cleaning supplies in childrens bathrooms
  • Lock back door and obtain chime.
  • Lock Laundry Room since cleaning supplies/toxins, chemicals will be stored there
  • Get childrens Gates for all stairs.
  • block area leading to 1545 Fulton St building.
  • Obtain microwave for heating up food.
Outdoor:
  • Self Latching gate not working for water fountain
  • Fence off fountain equipment
  • Fence off rose bushes
  • Fence off trash area.
  • Get Amended Fire Clearance.
Report Continued Onto LIC 809-C
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Juvenal Moctezuma
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: H.O.M.E. L.L.C.
FACILITY NUMBER: 103810184
VISIT DATE: 02/24/2022
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Pending a final file review and completion of above items, a recommendation will be made to license the above facility for a capacity of 60 school age children.

LPA reviewed with Applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

The following documents should be posted at the facility:

* PUB 269- Child passenger restraint systems poster 101225(f) Transportation


* Pub 393- Notification of Parents Rights 101218.1(c) Admission Procedures
* License 101160(a) License
* Menus 101227(a)(6) Food Services
* LIC 613A- Personal Rights form 101223(b)(2) Personal Rights
* LIC 610- Disaster Plan 101174(a)
* LIC 9148- Earthquake Preparedness Checklist 101174(b)
* Activity Schedule
* Lead Poisoning brochure

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Jaeda Ables.

No deficiencies cited during today's visit.


A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW.
THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Juvenal Moctezuma
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4