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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103907998
Report Date: 04/24/2023
Date Signed: 04/24/2023 10:14:11 AM

Document Has Been Signed on 04/24/2023 10:14 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:JACKSON, REGINA FAMILY CHILD CAREFACILITY NUMBER:
103907998
ADMINISTRATOR:JACKSON, REGINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 916-2336
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
04/24/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Regina JacksonTIME COMPLETED:
10:15 AM
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On 4/24/2023 Licensing Program Analyst Julie Baptista performed a licensee initiated case management visit The purpose of the visit was to inspect a new above ground spa recently installed at the home. LPA toured the day care room and back yard and took a census.
LPA observed a spa in the back yard which had a hard cover fitted to the spa and fastened with locks on two sides that can only be opened with a key making the spa inaccessible to children. LPA did not observe stairs to the spa. LPA did not observe any gaps or openings between the spa cover and spa rim. LPA observed the cover is heavy duty and can support the full weight of an adult. Licensee understands the spa cover must be in place and locked at all times when not in use and any steps to the spa must be removed when daycare children are present so that the spa is inaccessible to children.
Licensee stated the spa will be used for Licensee's personal use only and will be off-limits for day care children and during day care operating hours.
Licensee provided an updated Facility Sketch (LIC 999) of the backyard which includes the spa.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited. An exit interview was conducted with Licensee and a copy of this report and appeal rights were provided.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Julie Baptista
LICENSING EVALUATOR SIGNATURE: DATE: 04/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/24/2023
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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