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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103905726
Report Date: 11/28/2023
Date Signed: 11/28/2023 10:07:13 AM

Document Has Been Signed on 11/28/2023 10:07 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FERNANDEZ, ROSALVA FAMILY CHILD CAREFACILITY NUMBER:
103905726
ADMINISTRATOR:FERNANDEZ, ROSALVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 227-3642
CITY:FRESNOSTATE: CAZIP CODE:
93726
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
11/28/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:ROSALVA FERNANEZTIME COMPLETED:
10:15 AM
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On 11/28/2023, Licensing Program Analyst Stephanie Vega-Gonzalez conducted a Case Management that Licensee initiated. The purpose of the inspection was to inspect the newly remodeled kitchen inside the home and to inspect the front yard’s added cement ramp that children have access to. Today, LPA met with licensee Rosalva Fernandez. Also present was Staff 1, Licensee’s husband, and Licensee’s son. LPA toured the facility, and a census was taken of 7 children in care.

On today’s date LPA inspected the front yard cement ramp and observed that the ramp and hand railing is in good condition. LPA also inspected the kitchen and observed that the remolded kitchen is in good condition. LPA observed children in care to be supervised by Licensee and Assistant. LPA observed appropriate toys, books, chairs, children's table, cubbies, all in good condition for children in care. LPA did not observe any hazards to children in care. LPA inspected the kitchen, 2nd room, playroom, living room, 3rd bedroom, 5th bedroom, master bedroom, master bedroom bathroom, and hallway bathroom, and backyard which are accessible to children. LPA observed one small dog, and spoke to Licensee regarding best practice in cleaning up after pet.

There is a built-in swimming pool in the backyard which is fenced and made inaccessible. The pool gate is self-latching, self-closing and opens away from the swimming pool. No windows or doors have direct access to the pool area. LPA reviewed with Licensee Pool Regulations and provided a print out of pool regulations. LPA observed two small chairs, a water table and play tool table along the fence. LPA observed Licensee as she removed all items away from the fence gate. LPA informed Licensee to ensure that there are no chairs, tables, play structures aligning the pool fence. There were no children present in the backyard and door leading to the back yard was locked during today's inspection.

Capacity as specified on the license is being maintained. All adults in the home have a background clearance.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited today. Appeal rights were printed and given to Licensee.

An exit interview was conducted with Licensee, Rosalva Fernandez. Notice of Site Visit LIC9213 will be posted for 30 days.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2023
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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