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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620590
Report Date: 03/12/2025
Date Signed: 03/12/2025 11:41:11 AM

Document Has Been Signed on 03/12/2025 11:41 AM - 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:RIVERA, INGRID FAMILY CHILD CAREFACILITY NUMBER:
155620590
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/12/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Ingrid RiveraTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 3/12/2025, Licensing Program Analyst (LPA), Norma Lomeli met with Spanish-speaking Applicant, Ingrid Rivera for a pre-licensing inspection. Applicant, her boyfriend and her adult daughter 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 or exemptions.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • This is a single story, three bedrooms and two bathrooms home and children will have access to the living room, dining room, bedroom #3 (day care room) and hallway bathroom. Off-limits rooms/ closets are made inaccessible by use of child proof door knob covers, child proof lever available handle locks, and child proof safety gates.
  • There is central air heating/cooling ventilation for safety and comfort.
  • LPA observed in the day care room, child size furniture, safe toys, and books for the children. There is one high chair and two booster feeding chairs. There is a parents board mounted onto the right wall of the home's entry way. LPA discussed with applicant that the parents board must be readily to parents. There is a flat screen television mounted onto the living room wall. Children will nap in the living room on mats. 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 a 2A10BC fire extinguisher mounted the kitchen wall. There is a functioning smoke alarm, carbon monoxide alarm and first aid kit in place.
(Continued on LIC809-C):
SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2025
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 3
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: RIVERA, INGRID FAMILY CHILD CARE
FACILITY NUMBER: 155620590
VISIT DATE: 03/12/2025
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  • Applicant’s Pediatric CPR and First Aid certification was completed through American Red Cross and expires on 4/26/2026.
  • Preventative Health and Safety with Nutrition and Prevention of Lead exposure certification was completed on 6/8/2024.
  • Applicant completed the Mandated Reporter Training on 4/23/2024.
  • Knives and cleaning compounds stored inside the inaccessible kitchen pantry. Medications are stored inside a top kitchen cabinet.
  • 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 are four roosters and 26 chickens that are kept inside a chicken coop that is located in the inaccessible backyard. 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 key locked inside a Suncast storage shed that is located in the inaccessible backyard.
  • 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 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 not be accessible to the children. Applicant states children will not have outdoor play.
(Continued on LIC809-C):
SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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: RIVERA, INGRID FAMILY CHILD CARE
FACILITY NUMBER: 155620590
VISIT DATE: 03/12/2025
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  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
  • Applicant is advised it is her responsibility to read and maintain her facility incompliance with Title 22 Regulations. Title 22 Regulations can be found at www.ccld.ca.gov.
  • SB 792 immunizations are on file.
  • Applicant is advised Fresno Community Care Licensing Department has inspection authority and can inspect all rooms in the home, garages and/or separate dwellings on the premises.
  • 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 4:30 AM to 6:00 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.

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 3/17/2025.
SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
LIC809 (FAS) - (06/04)
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