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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620379
Report Date: 01/17/2024
Date Signed: 01/17/2024 04:17:37 PM

Document Has Been Signed on 01/17/2024 04:17 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:CHURCH, VALERIE FAMILY CHILD CAREFACILITY NUMBER:
155620379
ADMINISTRATOR:CHURCH, VALERIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 556-6368
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93314
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/17/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Valerie ChurchTIME COMPLETED:
04:30 PM
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On 1/17/24, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Valerie Church for a pre-licensing/ change of location inspection. Applicant, her husband, 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. Fire clearance was granted on 1/5/24.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • Fire clearance was received on 1/8/24. Applicant states that fire inspector did not require for her to install a fire pull alarm.
  • 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. Off-limits rooms/ closets are made inaccessible by use of door knob locks.
  • 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 a child size furniture and safe toys for the children. There is flat screen television on top of a large cabinet. There are two high chairs. LPA also observed a parents board on the right wall of the home's entry way. Children will nap in the living room on cots. Infants will nap in play yards. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout.
  • Facility has 4A80BC 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: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2024
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 4
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: CHURCH, VALERIE FAMILY CHILD CARE
FACILITY NUMBER: 155620379
VISIT DATE: 01/17/2024
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  • Applicant’s Pediatric CPR and First Aid certification was completed through HIS- EMS Safety with Emergency Medical Services Authority stickers (EMSA) and expires on 11/18/25. Applicant's Assistant, Shelly Sellers has not completed her CPR and First Aid training. Applicant understands that her assistant cannot be left alone to care for day care children.
  • Preventative Health and Safety with Nutrition and Prevention of Lead exposure certification has not been updated.
  • Medications are stored in the master bathroom. Cleaning compounds and knives are stored inside the cabinet that is located underneath the kitchen sink and made inaccessible by the use of a child proof safety latch.
  • 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 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. There is a hot tub in the backyard with a cover that is kept locked.
  • There are two dogs that are kept in inaccessible bedrooms. There is a 50 gallon fish tank with a tight fitted lid that is located in the living room. There are three horses kept in their inaccessible corral. There are 10 ducks kept in an area inaccessible to the day care children. Applicant is advised it is her 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 stored under key lock.
  • 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).


(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CHURCH, VALERIE FAMILY CHILD CARE
FACILITY NUMBER: 155620379
VISIT DATE: 01/17/2024
NARRATIVE
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  • 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.
  • Fenced backyard will have a fenced designated area for the children to play. LPA observed a child size picnic bench, a toddler playhouse, a caterpillar climber/crawler
  • Applicant will need to update the Mandated Reporter Training. Applicant completed the School Personnel training on 7/29/23. Applicant’s Assistant, Sherry Sellers completed the training on 8/9/23.
  • 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 7:00 AM to 5:00 PM and as arranged. No overnight care will be provided.


(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CHURCH, VALERIE FAMILY CHILD CARE
FACILITY NUMBER: 155620379
VISIT DATE: 01/17/2024
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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.

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 update the Preventative Health and Safety certification and provide LPA with proof of certification.
  • Applicant will complete the Mandated Report Training for Child Care Providers and provide LPA with proof of certification.
  • Applicant will provide LPA with proof of home ownership/or landlord consent.
  • Applicant will remove a bush stump that has sharp and pointy edges protruding from it. The bush stump is located in the children's designated play area.

Pending verification of corrections of the above items and a final review of her application, licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4