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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620774
Report Date: 02/18/2025
Date Signed: 02/18/2025 11:16:24 AM

Document Has Been Signed on 02/18/2025 11:16 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:BORJON COSBY, CYNTHIA FAMILY CHILD CAREFACILITY NUMBER:
155620774
ADMINISTRATOR/
DIRECTOR:		BORJON COSBY, CYNTHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 444-2667
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/18/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:10 AM
MET WITH:Cynthia Borjon CosbyTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On 2/18/2025, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Cynthia Borjon Cosby for a pre-licensing/ change of location inspection. Applicant, her Fiancé, her adult daughter 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. Fire clearance was granted on 1/29/2025.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • Fire clearance was received on 1/30/2025. Applicant states that fire inspector did not require for her to install a fire pull alarm.
  • This is a two story, five bedrooms and three bathrooms home and upstairs area will be off-limits to the day-care children. There is a gate at the bottom of the stairs making upstairs area inaccessible. Care and supervision will be provided in living room, family room (day care room), downstairs bedroom (play room), dining room, kitchen and downstairs bathroom. Off-limits rooms/ closets are made inaccessible by use of child proof door knob covers 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 a flat screen television mounted onto the wall. Also observed in play room, child size table, safe toys and educational posters. Children will nap in family room on mats. Applicant states she does not provide care for infants. She only cares for children ages 2 years and older.
(Continued on LIC809-C):
SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2025
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 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: BORJON COSBY, CYNTHIA FAMILY CHILD CARE
FACILITY NUMBER: 155620774
VISIT DATE: 02/18/2025
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Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout.
  • Facility has a 3A40BC fire extinguisher mounted onto the pantry wall. There is a functioning smoke alarm, carbon monoxide alarm and first aid kit in place.
  • Applicant’s Pediatric CPR and First Aid certification was completed through EMS Safety with Emergency Medical Services Authority stickers (EMSA) and expires on 2/7/2026. Applicant did not have proof of Assistant's, Chloe Cosby CPR and First Aid certification. Applicant understands that an adult assistant cannot be left alone to provide care and supervision to children if the assistant is not CPR and First Aid certified.
  • Preventative Health and Safety with Nutrition and Prevention of Lead exposure certification was completed on 2/5/2025.
  • Applicant completed the Mandated Reporter Training on 2/4/2024. Applicant’s assistant completed the training on 11/23/2024.
  • Knives and cleaning compounds are stored in the inaccessible kitchen pantry on a top shelf. Medications are stored in an upstairs bedroom and in the kitchen pantry on a top shelf.
  • 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 cat that is kept in an upstairs bedroom. Applicant states the cat will be 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, ammunition or poisons 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).
(Continued on LIC809-C):
SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2025
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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: BORJON COSBY, CYNTHIA FAMILY CHILD CARE
FACILITY NUMBER: 155620774
VISIT DATE: 02/18/2025
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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 item must be corrected and documentation be sent to Fresno CCL within the next 30 days to avoid possible withdraw.
  • Applicant will make inaccessible the air conditioner condenser unit that is located in the accessible backyard.

Pending verification of correction of the above ites 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: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2025
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: BORJON COSBY, CYNTHIA FAMILY CHILD CARE
FACILITY NUMBER: 155620774
VISIT DATE: 02/18/2025
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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 has cemented and sodded yard for the children. There is a Cedar Summit swings/slide play structure, a toddler picnic table, a basketball hoop, a tricycle, a child size table and chairs, balls and other safe toys.
  • 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 7:00 AM to 5:30 PM and as arranged. No overnight care will be provided.

(Continued on LIC809-C):

SUPERVISORS NAME: Scott Herring
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2025
LIC809 (FAS) - (06/04)
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