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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620254
Report Date: 02/07/2024
Date Signed: 02/07/2024 03:41:21 PM

Document Has Been Signed on 02/07/2024 03:41 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:RODRIGUEZ, JULISSIA FAMILY CHILD CAREFACILITY NUMBER:
155620254
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
02/07/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Julissa RodriguezTIME COMPLETED:
04:00 PM
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On 2/7/24, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Julissa Rodriguez for a pre-licensing inspection. Applicant, her husband, and one minor child 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 and children will have access to the living room, dining room, kitchen, and hallway bathroom. During today's inspection, applicant informed LPA that she would like to use the converted garage as the day care room. Applicant stated she purchase the home with the garage conversion room so she's unsure if the modified room is incompliance with city building permits. LPA observed in the converted garage room; a sink, electric cook top a refrigerator an air conditioner/heater wall unit, a smoke detector, a carbon monoxide alarm in the room. There is a bathroom with a sink and a mounted Safety Craft diaper changing station. Applicant understands that she must only use the converted garage room for temporary day care activities but never use the room for napping children. Applicant states that the day care entrance will be through the left side run of the home that leads to the converted garage room door. Off-limits rooms/ closets are made inaccessible by use of plastic door knob covers. Bedroom #3 and #4 are not made inaccessible.
(Continued on LIC809-C):
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2024
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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: RODRIGUEZ, JULISSIA FAMILY CHILD CARE
FACILITY NUMBER: 155620254
VISIT DATE: 02/07/2024
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  • There is a fireplace in the living room that applicant states it will not be used during day-care hours. There is central air heating/cooling ventilation for safety and comfort.
  • LPA observed in the living room; a sofa, a love seat and a flat screen television mounted onto the wall. Children will nap in the living room on mats. Infants will nap in play yard. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout.
  • Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
  • Applicant’s Pediatric CPR and First Aid certification was completed through HSI- EMS Safety with Emergency Medical Services Authority stickers (EMSA) and expires on 5/20/25.
  • Preventative Health and Safety with Nutrition and Prevention of Lead exposure certification was completed on 8/23/23.
  • Knives and medications are stored inside the kitchen pantry that is made inaccessible by the use of a child proof door knob cover. Cleaning compounds and poisons are stored in the laundry room closet that is kept key locked.
  • 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 are no bodies of water in the home or premises.
  • There is a five gallon fish tank with three fishes in a inaccessible bedroom.
  • Applicant states there are no firearms or ammunition in the home or premises.
  • 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.


(Continued on LIC809-C):
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: RODRIGUEZ, JULISSIA FAMILY CHILD CARE
FACILITY NUMBER: 155620254
VISIT DATE: 02/07/2024
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  • 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.
  • Fenced backyard has a cemented and sodded for the children. There is a Step 2 toddler play house, toddler slide and several toddler picnic benches. There is a patio porch for shade. LPA also observed a key locked shed where a barbecue grill, a utility ladder and other miscellaneous items are stored.
  • Applicant completed the Mandated Reporter Training on 11/30/23.
  • 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 4:00 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.


(Continued on LIC809-C):
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: RODRIGUEZ, JULISSIA FAMILY CHILD CARE
FACILITY NUMBER: 155620254
VISIT DATE: 02/07/2024
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Applicant is advised the following items must be corrected and documentation be sent to Fresno CCL within the next 30 days to avoid possible withdraw.
  • Applicant will make bedrooms #3 and #4 inaccessible to the day care children.
  • Applicant will make the right side run inaccessible to the day care children. LPA observed a wooden gate and a stack of roof tiles.

Pending verification of corrections of the above items and a final review of her application, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended.
SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC809 (FAS) - (06/04)
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