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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911833
Report Date: 04/11/2024
Date Signed: 04/11/2024 02:18:50 PM

Document Has Been Signed on 04/11/2024 02:18 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:NAVARRO, ESTHER FAMILY CHILD CAREFACILITY NUMBER:
103911833
ADMINISTRATOR/
DIRECTOR:		NAVARRO, ESTHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 375-4301
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
04/11/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Esther Navarro, LicenseeTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
NARRATIVE
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On 04/11/2024, Licensing Program Analysts (LPAs) Ka Vang and Yesenia Fierro arrived at the facility unannounced to conduct a Case Management-Other inspection. The purpose today’s inspection was to follow-up information that reported to the Fresno Community Care Licensing Office on 04/08/2024. LPAs met with Licensee Esther Navarro who speaks Spanish. An inspection tour of the facility was conducted, and census was taken. LPAs explained to Licensee that LPAs are following-up information that was received in the Fresno Community Care Licensing Office.

During the Case Management-Other inspection, Licensee was not able to provide children record for Child #1 (C1) for LPA to review. Licensee stated that C1 was attending the daycare home on 04/09/2024, but Licensee did not have C1’s record in file.

Licensee also disclosed that C1 sustained an injury in the daycare home on 04/08/2024. Per record review, Licensee did not report to Fresno Community Care Licensing Office next working day and during its normal business hours. In addition, a written report containing the information specified was not submitted to the Department within seven days following the occurrence of such event.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiencies are being cited during today’s inspection. (See next page, LIC809-D).



Licensee was provided a copy of appeal rights. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2024
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 2
Document Has Been Signed on 04/11/2024 02:18 PM - It Cannot Be Edited


Created By: Ka Vang On 04/11/2024 at 10:28 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: NAVARRO, ESTHER FAMILY CHILD CARE
FACILITY NUMBER: 103911833

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/11/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/25/2024
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 was not met as evidence by:
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Per Licensee, she agrees to watch the following videos on www.ccld.ca.gov regarding, Reporting Requirement and Record Keeping. Licensee agrees to submit proof to Licensing Fresno Office indicated that she watches and understand the Reporting Requirement and Record Keeping.
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Based on record review, the licensee did not comply with the section cited above. Licensee did not have a copy of the emergency information for Child #1 (C1) in file.
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Type B
04/25/2024
Section Cited
CCR102416.2(b)(3)(B)

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(b) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home…(B) Any injury to any child that requires medical treatment.
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Per Licensee, she agrees to watch the following videos on www.ccld.ca.gov regarding, Reporting Requirement and Record Keeping. Licensee agrees to submit proof to Licensing Fresno Office indicated that she watches and understand the Reporting Requirement and Record Keeping. Licensee agrees to report to the Department of the incident occurred on 04/08/2024 involved Child #1.
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Based on record review, the licensee did not comply with the section cited above. LPA Licensee disclosed that C1 sustained an injury in the daycare home on 04/08/2024. Per record review, Licensee did not report to Fresno Community Care Licensing Office next working day and during its normal business hours. Licensee failed to submit a written report containing the information to the Department within seven days.
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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.
SUPERVISOR'S NAME:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Ka Vang
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/11/2024


LIC809 (FAS) - (06/04)
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