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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911746
Report Date: 04/14/2023
Date Signed: 04/14/2023 02:02:16 PM

Document Has Been Signed on 04/14/2023 02:02 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:ANAYA VARGAS, ESMERALDA FAMILY CHILD CAREFACILITY NUMBER:
153911746
ADMINISTRATOR:ANAYA VARGAS, ESMERALDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 258-1544
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY: 14TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
04/14/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Esmeralda Anaya Vargas - Licensee TIME COMPLETED:
02:15 PM
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On 4/14/23, an unannounced Case Management Inspection was conducted by Licensing Program Analyst (LPA) Jessika Thompson. LPA met with Licensee Esmeralda Vargas Anaya, and toured the facility. Facility is operating Monday through Friday, from 6:00 AM to 6:00 PM. The purpose of today's inspection was to conduct a post licensing follow-up on the pre-licensing inspection that took place on 8/03/22. This is a two story, five bedroom, three bathroom home. There is a gate at the bottom of the stairs making upstairs area inaccessible to children. Care and supervision is provided in the living room, dining room, kitchen and downstairs bathroom. Off-limits room are made inaccessible by plastic door knob covers. There are no bodies of water or firearms on the premises. LPA reviewed children's files and confirmed 3 of 3 files assessed contain required information. Staff #2's file contains proof of immunization, Mandated Reporter Training, and CPR certification. LPA confirmed that the licensee maintains an updated Children’s Roster. Required forms are posted and Licensee completes a fire & disaster drill at least once every six months. Cribs and play yards are kept free from all loose articles and objects while infants are sleeping. Licensee is aware that there shall be no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. 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. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

LPA addressed an Unusual Incident that occurred at the home on 4/11/2023, concerning a child that slipped onto their arm while crawling the living room area. According to licensee, the child had recently begun to crawl faster, and the child's hand mistakenly slipped, causing the child to land awkwardly on their arm. Licensee stated that she witnessed the incident as it occurred and reported the incident to the child's parent thereafter. There were no visible signs of injury; however, the child was taken to see a physician as a precaution. No irregularities were found by the child's physician and the child retuned to care the next day (see LIC809-C).
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Jessika Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2023
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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ANAYA VARGAS, ESMERALDA FAMILY CHILD CARE
FACILITY NUMBER: 153911746
VISIT DATE: 04/14/2023
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This appears to be an isolated incident and LPA confirmed that the Licensee reported this incident to the Fresno Community Care Licensing office during the Department's normal business hours, before the close of the next working day following the occurrence.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies were cited 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: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023
LIC809 (FAS) - (06/04)
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