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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103810308
Report Date: 10/29/2025
Date Signed: 10/29/2025 03:56:12 PM

Document Has Been Signed on 10/29/2025 03:56 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FRESNO EOC MOSQUEDA HSFACILITY NUMBER:
103810308
ADMINISTRATOR/
DIRECTOR:		DAVALOS, ANGELICAFACILITY TYPE:
860
ADDRESS:4676 E BUTLERTELEPHONE:
(559) 263-1200
CITY:FRESNOSTATE: CAZIP CODE:
93702
CAPACITY: 20TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/29/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:SHAWNA WILBOURNTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On 10/29/2025, Licensing Program Analysts (LPAs), Stephanie Vega-Gonzalez and Nancy Her and Licensing Program Manager (LPM), Deborah Lowe conducted an announced Pre-Licensing inspection for a New License. Upon arrival, LPAs met with Facility Representatives Program Support Specialist, Shawna Wilbourn, Fresno EOC Head Start Director Michael Balderas, and Education Service Director Kim Bonnema. Facility Representatives are requesting to be licensed for 20 preschoolers ages 2-6 years in a modular building that is labeled as “Mosqueda Head Start”. Hours of operation will be Monday through Friday from 7:30 AM to 4:30 PM and run through a traditional school year. Children’s hours are 8:00 AM to 2:00 PM.

All indoor and outdoor activity space utilized for the children was inspected today. LPA Vega-Gonzalez informed Facility Representative that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities. When medications are on site, Facility Representatives stated that they will be located in the office modular building that is adjacent to the center/classroom. A fully equipped first aid kit is located inside the classroom. There is an operational carbon monoxide detector on site located inside the classroom. All required licensing documents were observed posted in the parent board inside the classroom. Children will be signed in and out at the classroom entrance.

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NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Stephanie Vega-Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/29/2025
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 5
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: FRESNO EOC MOSQUEDA HS
FACILITY NUMBER: 103810308
VISIT DATE: 10/29/2025
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LPAs and LPM continued to tour the facility and measured all indoor and outdoor activity space. Total indoor activity space measured at an estimate 675 square feet, which is not sufficient to accommodate the requested overall capacity of 20 Children, and will accommodate only 19 children.

LPAs and LPM observed all indoor activity space to be complete with safe, age-appropriate furniture and equipment, including tables, chairs, cubbies, bookshelves, and other activity supplies for the children. Preschool toys are safe with no sharp edges, splinters, or points, nor made of small parts that can present a choking hazard. Drinking water is available in the classrooms via a portable water dispenser and disposable cups. LPA Vega-Gonzalez observed all hazardous items to be inaccessible to children. There are no weapons on the property. LPAs and LPM observed a pool and water features/splash pad located within the property. The pool and water features/splash park belongs to the city park/community center and facility has two modulars within the property. LPAs and LPM observed that the pool metal fence measures at least 6ft, has a padlock, and is inaccessible to children in care. Facility Representative stated that children will not be using the pool or water features/splash pad located in the park/community center. There are buildings that are in between the facility and the pool and water features/splash pad, and the center would be closed during the summer months. Fire clearance was granted by Fresno City Fire Department on 10/06/2025.

LPAs and LPM observed a total of 2 sinks and 2 toilets available for children’s use. These are sufficient to accommodate the requested overall capacity of 20 children. There is a separate staff restroom equipped with a toilet and a sink. The isolation area for children who are ill will be the facilities office that is a modular that is adjacent to the center’s classroom.

Facility will provide breakfast, lunch, and PM snack. The facility has a fridge and kitchenette that is located inside the classroom. Facility Representative stated that nonperishable items will be stored inside the office building. The facility currently does not have any food stored. LPA reviewed with facility representative that the kitchen area and food storage areas will need to be free of rodents and/or vermin as per regulation.

(Continue on LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Stephanie Vega-Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025
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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: FRESNO EOC MOSQUEDA HS
FACILITY NUMBER: 103810308
VISIT DATE: 10/29/2025
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Facility Representative was informed that food will need to be properly stored separate from cleaning materials. LPAs and LPM did not observe any hazardous items in kitchenette area. Facility Representative stated that children will not have access to any hazardous items.

The facility currently has a fully fenced playground area for the preschool component Fencing is made of metal and is at least four feet high. The total square footage for all the outdoor activity space for the preschool is 2,953 square feet which is sufficient to accommodate the requested capacity. Shade is provided via a shade structure. LPAs and LPM observed that the playground climber is in need of repair. LPA Vega-Gonzalez observed that there was paint peeling off the metal railings, had dark smudges, dry paint with woodchips, and play climber has no age verification information. LPA observed that the playground climber was properly anchored. There is adequate cushioning in fall zones of climber provided by woodchips. Drinking water is available via portable water dispenser and disposable cups. LPAs and LPM observed all hazardous items on the playground to be inaccessible to children. Facility Representative was reminded that any changes to the facility must be reported to and approved by Community Care Licensing.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

Facility representative 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

(Continue on LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Stephanie Vega-Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025
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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: FRESNO EOC MOSQUEDA HS
FACILITY NUMBER: 103810308
VISIT DATE: 10/29/2025
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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A 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) or (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

LPA Vega-Gonzalez reviewed with Facility representatives the LIC 311A, Records to Be Maintained at The Facility, for child’s records, personnel records, administrative records, and documents to be posted. A hard copy was provided during visit..

Facility Representatives were informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms. 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.

The following corrections are needed prior to the issuance of the license:


· Submission of the remaining requested licensing documents as requested via the Notice of Incomplete Application (NOIA) letter from the Department.
· Playground climbing structure in need of repair. Paint peeling off metal rails in need of repaint and climber in need of a wash.
· Verification that the outdoor climbing structure is age appropriate.
· A declaration verifying that facility will not use city pool and water feature/splash pad area.
· Clarification regarding exclusivity of the playground.
· Updated LIC 200A to reflect the updated capacity due to measurements.

Exit interview conducted and report was reviewed with the Facility representatives. Facility Representative, Shawna Wilbourn understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.
NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Stephanie Vega-Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025
LIC809 (FAS) - (06/04)
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