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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911875
Report Date: 08/11/2022
Date Signed: 08/11/2022 11:07:40 AM

Document Has Been Signed on 08/11/2022 11:07 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:LOPEZ, LAURA FAMILY CHILD CAREFACILITY NUMBER:
153911875
ADMINISTRATOR:LOPEZ, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 428-5219
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
08/11/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Laura LopezTIME COMPLETED:
11:30 AM
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On 08/11/22, Licensing Program Analyst (LPA) Gloria Reyes conducted a case management inspection. LPA met with Licensee, Laura Lopez. The purpose of today's visit is to conduct a 90 Day follow-up on initial prelicensing visit and 8 children are present. Background clearances were reviewed and verified. This facility is licensed as a large facility of 14, there must be an additional qualified staff person present anytime the facility goes beyond the ratio for a capacity of eight. A tour of the home, inside and outside, as shown on the facility sketch was done. The children will have access to the living room, bedroom #3, hallway bathroom, dining room, and backyard.

Required forms are posted. Staff and some Children's files were reviewed today and licensee documents immunizations and maintains and updates records for children in care. Licensee conducts fire and disaster drills at least once every six months and document the date and time of each drill. Fire extinguisher, smoke detector, carbon monoxide detector and first aid kit are operable and in place. Licensee stated there are no firearms or "bodies of water" in this home and nor did LPA observe these items. There is a fireplace in the living room that licensee states it will not be used during day-care hours. Fireplace is covered with a wood board.

Health and Safety training, Pediatric CPR, and Pediatric First Aid training are current and expires on 07/2023 for licensee and assistant. LPA verified that the required immunizations and the required Mandated Child Abuse Reporter (AB 1207) training was completed on 05/29/22.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm. (see next page)

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Gloria Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022
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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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: LOPEZ, LAURA FAMILY CHILD CARE
FACILITY NUMBER: 153911875
VISIT DATE: 08/11/2022
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LPA reviewed Safe Sleep guidelines with licensee. Days/Hours of Operation: Monday through Friday, 5:00 AM to 5:00 PM.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency cited.

Exit interview conducted with licensee. A copy of this report was provided and discussed. A Notice of Site Visit Form was posted to parent's board and must remain posted for 30 days.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Gloria Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2