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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911697
Report Date: 07/13/2022
Date Signed: 07/13/2022 10:55:49 AM

Document Has Been Signed on 07/13/2022 10:55 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:RUIZ REYES, MAYRA FAMILY CHILD CAREFACILITY NUMBER:
153911697
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 4DATE:
07/13/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Mayra Ruiz Reyes - Licensee TIME COMPLETED:
11:10 AM
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On 7/13/22, an unannounced Case Management inspection was conducted today by Licensing Program Analyst (LPA) Jessika Thompson. LPA Thompson met with licensee, Mayra Ruiz Reyes, and toured the facility, inside and outside. Facility is operating Monday through Friday, from 7:30 AM to 5:30 PM There were four day-care children present. The purpose of today's inspection was to conduct a 90 Day follow-up on the initial pre-licensing inspection that took place on 3/07/22. Accessible rooms are the living room, dining room/kitchen, day-care restroom, and day-care bedroom. Off-limit rooms are made inaccessible by use of door locks. There are no "bodies of water" or weapons at this residence. Children's files were reviewed and LPA provided licensee with technical assistance regarding missing forms. LPA discussed with licensee the requirement of maintaining a Children’s Roster and completing fire and disaster drills every six months. Required forms are posted. The backyard is off-limits to children. Safe sleep regulations were discussed. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Provider Information Notices were discussed, and licensee is aware that forms and updated information may be obtained on the Department's website (www.ccld.ca.gov). LPA discussed Required 1-Year inspections with the licensee, detailing what to expect. Reporting requirements were discussed and Licensee understands that unusual incidents must be reported the Fresno Community Care Licensing office during the Department's normal business hours, before the close of the next working day following the occurrence.

Incidental Medical Services (IMS) policy were discussed. Currently, Licensee does not have any children enrolled requiring IMS. Licensee understand that if/when any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies are observed today. An exit interview was conducted with Licensee and appeal rights were provided.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Jessika Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022
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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