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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911960
Report Date: 05/15/2023
Date Signed: 05/15/2023 10:56:18 AM

Document Has Been Signed on 05/15/2023 10:56 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:HOWARD, AMINA FAMILY CHILD CAREFACILITY NUMBER:
103911960
ADMINISTRATOR:HOWARD, AMINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 668-4535
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
05/15/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Amina HowardTIME COMPLETED:
11:00 AM
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On 05/15/2023, Licensing Program Analyst (LPA), Jeovanna Yanez met with Applicant, Amina Howard for a pre-licensing inspection. Applicant and three minor children reside in the home. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance. Fire clearance was granted on January 27, 2023.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
· Fire clearance was received on February 3, 2023. Fire pull alarm is located on the home’s hallway on the left hand side wall.
· This is a two story three bedroom, two and half bathroom home and upstairs area will be off-limits to the day-care children. There is a gate at the bottom of the stairs that does not meet Title 22 regulations. Care and supervision will be provided in the living room, dining room, kitchen, and downstairs bathroom.
· There is no fireplace in the home.
· In the living room, LPA observed a flat screen television mounted on a stand, comfortable furnishings, learning wall art, a play kitchen, and safe games, toys, and books for the children. Children will nap on cots, infants will nap in play yards in the living room. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout.
· Facility has 2A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. (CONTINUED ON 809-C)
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE: DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/15/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: HOWARD, AMINA FAMILY CHILD CARE
FACILITY NUMBER: 103911960
VISIT DATE: 05/15/2023
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· Applicant’s Pediatric CPR and First Aid certification was completed through HSI Pediatrics with Emergency Medical Services Authority stickers (EMSA) and expires on October 29, 2024.
· Preventative Health and Safety Course with Prevention of Lead exposure certification was completed on February 17, 2023.
· Knives are stored in a bottom kitchen drawer made inaccessible via safety latch. Medications and cleaning compounds are stored in the upstairs master bathroom.
· Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
· Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
· There are no bodies of water in the home or premises.
· There are two dogs that are kept in the off-limits upstairs master bedroom. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
· Applicant states there are no firearms or ammunition in the home or premises.
· Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
· Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
· Applicant states she will be transporting day care children. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.
· LPA inspected the fenced backyard which will be off limits to the day care children. LPA observed various parts of the fence that need to be replaced/repaired. Prior to use, Applicant will contact Licensing to come clear backyard for day-care use.
· SB 792 immunizations verified and on file.
· Applicant completed the Mandated Reporter Training on February 21, 2023.
(CONTINUED ON 809-C)
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023
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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: HOWARD, AMINA FAMILY CHILD CARE
FACILITY NUMBER: 103911960
VISIT DATE: 05/15/2023
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· LPA discussed safe sleep regulations and Safe Sleep Concepts were given to applicant.
· Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. When any IMS is provided, a Plan for Providing 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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. Applicant is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday, 24 hours. Overnight care will be provided. “Overnight Care" means care being provided to children anytime between the hours of 6:00 PM and 6:00 AM. Care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered into care.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.



Applicant is advised the following item must be corrected and documentation be sent to Fresno CCL within the next 30 days to avoid possible withdraw.
· Applicant will barricade the bottom of the stairs and will provide LPA with proof.

Pending verification of correction of the above item and a final review of her application, licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended.
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023
LIC809 (FAS) - (06/04)
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