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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103912691
Report Date: 06/10/2026
Date Signed: 06/10/2026 02:15:20 PM

Document Has Been Signed on 06/10/2026 02:15 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:PEREZ, SANDRA FAMILY CHILD CAREFACILITY NUMBER:
103912691
ADMINISTRATOR/
DIRECTOR:		PEREZ, SANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 458-1392
CITY:FIREBAUGHSTATE: CAZIP CODE:
93622
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 3DATE:
06/10/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
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On 06/10/2026 Licensing Program Analysts (LPAs), Miguel Herrera and Kimberly Vass conducted an unannounced Annual Random Inspection and was met by licensee Sandra Perez. Days and hours of operation are Monday through Friday from 5:00 AM to 5:00 PM.

LPA toured the home inside and outside and a census was taken. LPA reviewed current facility sketch and confirmed that the living room, dining room, kitchen, bedroom 2, bedroom 3, hallway bathroom and backyard are accessible to children. Off-limits rooms are made inaccessible by use of doorknob spinners. This is a single level home and there are no stairs. The home has working telephone service and LPA confirmed the phone number.

Upon entering the living room LPAs observed the tile floor to be cracked and lifting as LPAs stepped on the tile floor. LPAs observed a large area of the tile floor that needed to be repaired as it posed a safety risk to children in care (See 809-D for further details).

During the inspection of the kitchen, LPAs observed 2 medication organizers, a prescription medication bottle, a vitamin bottle and Clorox wipes sitting on the kitchen counter which were accessible to daycare children (See 809-D for further details). LPAs also observed a pet shock collar with remote, a foldable multi-tool and a sharp screwdriver in an accessible kitchen drawer (See 809-D for further details).

Continued on 809-C.

NAME OF LICENSING PROGRAM MANAGER: Jose Penate
NAME OF LICENSING PROGRAM ANALYST: Kimberly Vass
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/10/2026
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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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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Document Has Been Signed on 06/10/2026 02:15 PM - It Cannot Be Edited


Created By: Kimberly Vass On 06/10/2026 at 11:49 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: PEREZ, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 103912691

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(5)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above as there was a kiddie pool accessible to chidlren in care which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/10/2026
Plan of Correction
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Licensee stated she will drain the pool and remove the pool from the premise and will no longer use the pool.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Jose Penate
NAME OF LICENSING PROGRAM MANAGER:
Kimberly Vass
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/10/2026


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/10/2026 02:15 PM - It Cannot Be Edited


Created By: Kimberly Vass On 06/10/2026 at 11:49 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: PEREZ, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 103912691

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/10/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, the licensee did not comply with the section cited above as LPAs observed loose and cracked tiles in the livingroom with jagged edges which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2026
Plan of Correction
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Licensee stated she will have the tile flooring repaired by POC deadline 06/24/2026 and send photographic evidence via email/text.
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, the licensee did not comply with the section cited above as LPAs observed 2 medication organizers, a prescription medication bottle, a vitamin bottle and clorox wipes sitting on the kitchen counter, and a pet shock collar with remote, a foldable multi-tool and screwdriver in an accessible kitchen drawer, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/15/2026
Plan of Correction
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Licensee immediately removed the vitamins, medications and clorox wipes and stored them out of children's reach. Licensee also immediately removed the pet shock collar with remote, a foldable multi-tool and a sharp screwdriver and stored out of reach of daycare children. Licensee will review the above referenced regulation and will write a short statement as how she will make dangerous items inaccessible to children in care. The statement will be submitted to CCLD Fresno by 06/15/2026 via email/text.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Jose Penate
NAME OF LICENSING PROGRAM MANAGER:
Kimberly Vass
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/10/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/10/2026


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: PEREZ, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 103912691
VISIT DATE: 06/10/2026
NARRATIVE
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There are no firearms or ammunition on the premises. No poisons were observed during the inspection.

There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles.

The outdoor play area in the backyard is fenced. LPAs observed an accessible kiddie pool filled with water in the backyard. Licensee stated the pool is for her two dogs, which LPAs observed to be in the backyard. Licensee stated that she refills the pool in a daily basis for the dogs as it gets muddy. Licensee stated the children had not been outside and that she understands that this poses a health and safety risk to daycare children (See 809-D for further details).

Licensee has two large dogs in the backyard. Licensee understand the liability of pets around day care children and accepts responsibilities of any action taken by pets.

Capacity as specified on the license is being maintained. LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. A fire drill was completed on 05/20/26. Licensee’s Mandated Reporter Training was completed on 05/28/26. Licensee’s pediatric CPR/First Aid certification expires on 12/2026. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

Continued on 809-C.

NAME OF LICENSING PROGRAM MANAGER: Jose Penate
NAME OF LICENSING PROGRAM ANALYST: Kimberly Vass
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2026
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: PEREZ, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 103912691
VISIT DATE: 06/10/2026
NARRATIVE
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Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Continued on 809-C.

NAME OF LICENSING PROGRAM MANAGER: Jose Penate
NAME OF LICENSING PROGRAM ANALYST: Kimberly Vass
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2026
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: PEREZ, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 103912691
VISIT DATE: 06/10/2026
NARRATIVE
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Exit interview conducted and report was reviewed with licensee Sandra Perez. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, of the California Code of Regulations, the following deficiencies are being cited: (see next page). Licensee Sandra Perez was provided appeal rights.

LPAs Miguel Herrera and Kimberly Vass informed licensee that this report dated 06/10/2026 documents 1 Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPAs Miguel Herrera and Kimberly Vass informed the licensee to provide a copy of this licensing report dated 06/10/2026 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 Acknowledgement of Receipt of Licensing Reports was given to Licensee Sandra Perez.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Jose Penate
NAME OF LICENSING PROGRAM ANALYST: Kimberly Vass
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/10/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2026
LIC809 (FAS) - (06/04)
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