105620750-1-24-2025-57-CC-NLOI-DD82VH-20250123164357

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 105620750
Report Date: 01/23/2025
Date Signed: 01/24/2025 04:06:30 PM

Document Has Been Signed on 01/24/2025 04:06 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 SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	RODRIGUEZ, ANA FAMILY CHILD CARE		FACILITY NUMBER:	105620750
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	01/23/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	03:30 PM
MET WITH:	Ana Rodriguez		TIME VISIT/ INSPECTION COMPLETED:	04:50 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 1/23/2025, Licensing Program Analysts (LPAs), Norma Lomeli and Jose Ruiz met with Applicant, Ana Rodriguez for a pre-licensing/ change of location inspection. Applicant, her husband and one 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 or exemption. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: This is a single story, four bedrooms and two bathrooms home and children will have access to the living room, (day care room), dining room, kitchen, laundry room and hallway bathroom. Off-limits rooms/ closets are made inaccessible by use of door knob locks. There is a fireplace in the living room that applicant states it will not be used during day-care hours. There is central air heating/cooling ventilation for safety and comfort. LPA observed in the day care room, a sectional, a flat screen television mounted onto the living room wall, an infant swing and safe toys. There is a high chair in the dining room. Children will nap in the day care room on mats. Infants will nap in play yards. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. Facility has 3A40BC fire extinguisher stored inside cabinet that is located underneath the kitchen sink and made inaccessible by the use of a sliding cabinet latch. There is a functioning smoke alarm, carbon monoxide alarm and first aid kit in place. (Continued on LIC809-C):

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

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 SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: RODRIGUEZ, ANA FAMILY CHILD CARE	FACILITY NUMBER: 105620750
	VISIT DATE: 01/23/2025

NARRATIVE

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Applicant’s Pediatric CPR and First Aid certification was completed through American Red Cross and expires on 3/8/2026.
Applicant’s Pediatric CPR and First Aid certification was completed through American Red Cross and expires on 3/8/2026.
Preventative Health and Safety with Nutrition and Prevention of Lead exposure certification was completed on 4/16/2024.
Knives and medications are stored inside top kitchen cabinet. Cleaning compounds are stored inside a top cabinet in the laundry room. Others are stored in the inaccessible garage.
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.
Applicant states there are no pets in the home or on the premises.
Applicant states there are no firearms or ammunition in the home or premises. Poisons are stored key locked inside a shed that is located in the backyard.
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.
Fenced backyard has a cemented and sodded yard for the children. There is an outdoor sink with running water. There are safe toys and a patio porch for shade.

(Continued on LIC809-C):

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

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 SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: RODRIGUEZ, ANA FAMILY CHILD CARE	FACILITY NUMBER: 105620750
	VISIT DATE: 01/23/2025

NARRATIVE

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LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
Applicant is advised it is her responsibility to read and maintain her facility incompliance with Title 22 Regulations.Title 22 Regulations can be found at www.ccld.ca.gov.
SB 792 immunizations are on file.
Applicant is advised Fresno Community Care Licensing Department has inspection authority and can inspect all rooms in the home, garages and/or separate dwellings on the premises.
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 and as arranged. 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.

LPAs & applicant discussed the Community Care Licensing website: LPAs 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.
(Continued on LIC809-C):

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

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 SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: RODRIGUEZ, ANA FAMILY CHILD CARE	FACILITY NUMBER: 105620750
	VISIT DATE: 01/23/2025

NARRATIVE

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Applicant is advised the following items must be corrected and documentation be sent to Fresno CCL within the next 30 days to avoid possible withdraw.

Applicant will make inaccessible a air conditioner unit that has electrical wires exposed and accessible. The unit is located in the backyard. Applicant will provide LPA with picture(s) of correction.

Pending verification of corrections of the above items and a final review of her application, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended.

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025

LIC809 (FAS) - (06/04)

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