155620801-5-21-2025-57-CC-NLOI-DGVUAN-20250521152500

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 155620801
Report Date: 05/21/2025
Date Signed: 05/21/2025 03:25:13 PM

Document Has Been Signed on 05/21/2025 03:25 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:	ALVAREZ, ANGELICA FAMILY CHILD CARE		FACILITY NUMBER:	155620801
ADMINISTRATOR/ DIRECTOR:	ALVAREZ, ANGELICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 333-9116
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93307
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/21/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:30 PM
MET WITH:	Angelica Alvarez		TIME VISIT/ INSPECTION COMPLETED:	03:30 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 5/21/25, Licensing Program Analyst (LPA), Norma Lomeli met with Spanish-speaking Applicant, Angelica Alvarez for a pre-licensing inspection. Applicant, her two adult daughters and four 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 3/17/25. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: Fire clearance was received on 3/25/25. Fire pull alarm is located on the home’s entry way on the left wall of the home’s entry way. This is a single story, three bedrooms and one bathroom home, there is an inaccessible living quarters (converted garage) with one bedroom, living room and bathroom. Children will have access to the living room (day care room), dining room, and hallway bathroom. Off-limits rooms/ closets are made inaccessible by use of key locks and a retractable child proof safety gate. There is an Avana mini split ventilation for safety and comfort located in the day care room. There is a double sided wall heater in the living room that applicant states it will not be used during day care hours. Applicant states she will use a portable heater that will be inaccessible to the day care children. (Continued on LIC809-C):

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Norma Lomeli
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: ALVAREZ, ANGELICA FAMILY CHILD CARE	FACILITY NUMBER: 155620801
	VISIT DATE: 05/21/2025

NARRATIVE

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LPA observed in the day care room, child size furniture, safe toys, and educational posters for the children. There is a diaper changing table and a flat screen television mounted onto the living room wall. LPA observed a parents board on the right wall of the home’s entry way. LPA advised applicant the parents board must be readily available for parents to view. Children will nap in the day care 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 a 2A10BC fire extinguisher mounted onto the left wall of the home’s entry way. There is a functioning smoke alarm, carbon monoxide alarm and first aid kit in place.
Applicant and Applicant’s Assistant, Edith Gonzalez completed Pediatric CPR and First Aid certification through EMS Safety with Emergency Medical Services Authority stickers (EMSA) and expires on 10/26/26.
Applicant completed the Preventative Health and Safety with Nutrition and Prevention of Lead exposure certification was completed on 11/7/24. Applicant’s assistant completed the training on 2/21/25.
Applicant completed the Mandated Reporter Training on 5/4/25. Applicant’s assistant completed the training on 4/3/25.
Knives are stored inside a kitchen drawer made inaccessible by the use of a child proof safety latch. Medications are stored inside a top kitchen cabinet. Cleaning compounds are stored inside the cabinet that is located underneath the kitchen sink and made inaccessible by the use of a cabinet child safety latch. The kitchen is made inaccessible by the use of a retractable child proof safety gate.
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.

(Continued on LIC809-C):

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Norma Lomeli
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

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: ALVAREZ, ANGELICA FAMILY CHILD CARE	FACILITY NUMBER: 155620801
	VISIT DATE: 05/21/2025

NARRATIVE

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There is a dog that is kept 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 not stored key locked. LPA observed three containers of insect killer.
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 day children. Applicant will use fenced the front yard for the day care children. LPA observed a wooden slide play structure that is not anchored to the ground, there is a Little Tikes play house and other safe toys. LPA also observed a patio bench and chairs.
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.

(Continued on LIC809-C):

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Norma Lomeli
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

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: ALVAREZ, ANGELICA FAMILY CHILD CARE	FACILITY NUMBER: 155620801
	VISIT DATE: 05/21/2025

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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 Saturday from 5:00 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.

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 store poisons under key lock.
Applicant will anchor to the surface a wooden slide play structure that is located in the fenced front yard.

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.

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Norma Lomeli
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2025

LIC809 (FAS) - (06/04)

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