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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620021
Report Date: 07/26/2022
Date Signed: 07/26/2022 02:52:57 PM

Document Has Been Signed on 07/26/2022 02:52 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:ZARAGOZA, STEPHANIE FAMILY CHILD CAREFACILITY NUMBER:
155620021
ADMINISTRATOR:ZARAGOZA, STEPHANIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 778-8636
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: 0DATE:
07/26/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Stephanie ZaragozaTIME COMPLETED:
03:00 PM
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Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On July 26, 2022, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Stephanie Zaragoza for a pre-licensing/ change of location inspection. Applicant, her husband and three 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. Fire clearance was granted on July 20, 2022.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • Fire clearance was received on July 20, 2022. Fire alarm is located on the home’s office (day care room), on the right hand side wall.
  • This is a single story, four bedrooms and three bathrooms home and children will have access to the living room, office (day care room), dining room, kitchen, laundry room and hallway bathroom #2. Off-limits rooms are made inaccessible by use of plastic door knob covers. The entrance to the home day care will be through the black gate that is located on the left side run of the home.
  • There is a fireplace in the living room that applicant states will not be used during day-care hours.
  • LPA observed children size furniture, safe toys, and books for the children. Children will nap in the living room and day care room on mats. Infants will nap in play yards. Applicant understands she is to supervise children at all times.
  • Facility has 2A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 07/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/26/2022
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: ZARAGOZA, STEPHANIE FAMILY CHILD CARE
FACILITY NUMBER: 155620021
VISIT DATE: 07/26/2022
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  • Applicant’s Pediatric CPR and First Aid certification was completed through EMS Safety, applicant states that she will be obtaining the approved Emergency Medical Services Authority stickers (EMSA) within a month. Certification expires on March 13, 2024. Applicant’s Assistant, Juan Zaragoza completed the training through Pediatric Plus with Emergency Medical Services Authority stickers (EMSA) and expires on January 27, 2023.
  • Preventative Health and Safety with Prevention of Lead exposure certification was completed on June 16, 2022.
  • Knives are stored in a top kitchen cabinet inside a plastic container. Medications are stored in the inaccessible master bedroom. Cleaning compounds are stored in the cabinet that is located underneath the kitchen sink and made inaccessible by the use of magnetic lock.
  • 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 is an in-ground pool that is fenced with All Safe black mesh fencing in accordance with Title 22 Regulations. The gate is self-latching/self-closing, swings away from the pool and latching device is located no more than six inches from the top of the gate.
  • Applicant states there are no pets in the home or on the premises.
  • Applicant states there are no firearms or ammunition. Poisons in the home are kept locked.
  • 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 not 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.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022
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: ZARAGOZA, STEPHANIE FAMILY CHILD CARE
FACILITY NUMBER: 155620021
VISIT DATE: 07/26/2022
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  • Fenced backyard has a gated play area on the left side run of the home for the day care children. LPA observed a Step 2 play house and a toddler table with chairs. There is a Radio Flyer tricycle, a Lakeshore white board and a water table.
  • SB 792 immunizations verified and on file.
  • Applicant completed the Mandated Reporter Training on March 13, 2022. Applicant’s Assistant, Juan Zaragoza completed the training on January 26, 2021.
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
  • 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 from 5:00 AM to 5:00 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA 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.



Licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended effective August 1, 2022.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2022
LIC809 (FAS) - (06/04)
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