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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620120
Report Date: 04/13/2023
Date Signed: 04/13/2023 03:49:57 PM

Document Has Been Signed on 04/13/2023 03:49 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:LOPEZ, JOSELYN & PEREZ, YEESENIA FCCFACILITY NUMBER:
155620120
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/13/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Joselyn Lopez and Yesenia PerezTIME COMPLETED:
04:00 PM
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On 4/13/23, Licensing Program Analyst (LPA), Norma Lomeli met with Applicants, Joselyn Lopez and Yesenia Perez for a pre-licensing inspection. Applicants, four adults and two 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.

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 including a converted garage/Mother in Law Suite, (day care room), that will be used for day care and children will only have access to the day care room and bathroom. Applicants provided LPA with City of Bakersfield Building Department, Inspection Record and Building Permit documentation. LPA observed a heating/cooling wall unit for heating and ventilation. Off-limits rooms are made inaccessible by use of plastic door knob covers.
  • There is no fireplace in the home.
  • LPA observed children size furniture, safe toys, and books for the children. There is a flat screen television mounted onto the wall. There is a play yard. Children will nap in the day care room on cots. Infants will nap in play yards. There is a parents board on the right hand side wall. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. (0-24 months old).
  • Facility has 3A40BC 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: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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: LOPEZ, JOSELYN & PEREZ, YEESENIA FCC
FACILITY NUMBER: 155620120
VISIT DATE: 04/13/2023
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  • SB 792 immunizations verified and on file.
  • Applicant, Joselyn Lopez completed the Mandated Reporter Training on 11/18/22. Applicant, Yesenia Perez completed the Mandated Reporter Training on 12/19/22.
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicants.
  • 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. Applicants are advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. Applicants are also reminded that it is their responsibility to read the regulations periodically. Applicants state they will operate their day care Monday through Friday, 24 hours a day. 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.

LPA & applicants discussed the Community Care Licensing website: LPA and applicants 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.

Pending a final review of application file, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended effective 4/17/23.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
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, JOSELYN & PEREZ, YEESENIA FCC
FACILITY NUMBER: 155620120
VISIT DATE: 04/13/2023
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  • Applicants completed Pediatric CPR and First Aid certification through Pediatric Plus with Emergency Medical Services Authority stickers (EMSA) and expires on 9/7/24.
  • Preventative Health and Safety with Prevention of Lead exposure certification was completed on 10/20/22.
  • Knives and medications are stored in the kitchen which is an area inaccessible to the day care children. Cleaning compounds are stored inside the cabinet that is located underneath the kitchen sink and others are stored inside a hallway closet and in the laundry room.
  • Advised applicants 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.
  • Applicants are 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.
  • There is a dog that is kept in the inaccessible backyard. Applicants are advised it is their responsibility to ensure the safety of children in care at all times from the pets.
  • Applicant states there are no firearms or ammunition in the home or premises. Poisons are kept locked inside a shed that is located in the backyard.
  • Applicants are 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).
  • Applicants are 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.
  • Applicants state they 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 will be inaccessible to the day care children. Applicants state that they will be transporting the day care children to a nearby park. Applicants understand that they must have 100% visual supervision of children when playing outdoors.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC809 (FAS) - (06/04)
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