<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620120
Report Date: 06/20/2023
Date Signed: 06/20/2023 04:33:20 PM

Document Has Been Signed on 06/20/2023 04:33 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: 5CENSUS: 2DATE:
06/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:50 PM
MET WITH:Yesenia Perez & Joselyn LopezTIME COMPLETED:
04:45 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 6/20/23, an unannounced Case Management inspection was conducted by Licensing Program Analyst (LPA) Jessika Thompson. LPA met with licensees, Yesenia Perez & Joselyn Lopez, and toured the facility. Facility is operating Monday through Friday, less than 24 consecutive hours per child. The purpose of today's inspection was to conduct a post licensing follow-up on the initial pre-licensing inspection that took place on 4/13/23. Accessible rooms are the day-care room and inclusive restroom. Off-limit areas are made inaccessible by use of doorknob spinners. The backyard is off limit to day-care children. There are no bodies of water or weapons at this residence. Children's files were reviewed and LPA discussed with licensees the requirement of maintaining a Children’s Roster and completing fire and disaster drills every six months. Required forms are posted. Safe sleep regulations were discussed.

Provider Information Notices were discussed, and licensees are 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 licensees, detailing what to expect. Reporting requirements were discussed and licensees understand 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, licensees do not have any children enrolled requiring IMS. Licensees 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 were cited. An exit interview was conducted with licensees and appeal rights were provided.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Jessika Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 06/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1