163911155-9-10-2026-57-CC-XXAG-DXSPZY-20260910114619

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 163911155
Report Date: 09/10/2026
Date Signed: 09/10/2026 11:46:35 AM

Document Has Been Signed on 09/10/2026 11:46 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:	RIOS DE GONZALEZ, ROSA FAMILY CHILD CARE		FACILITY NUMBER:	163911155
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 9	CENSUS: 5	DATE:	09/10/2026
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Licensee Rosa Rios De Gonzalez		TIME VISIT/ INSPECTION COMPLETED:	12:00 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 September 10, 2026, Licensing Program Analyst (LPA) Xona Xayavong conducted an unannounced Annual Random Inspection and a Capacity Increase Inspection for the conversion from a Small Family Child Care Home to a Large Family Child Care Home. LPA met with licensee Rosa Rios De Gonzalez. The licensee, one adult daughter, and one minor child reside in the home. A tour of the home, inside and outside, was conducted, and a census was taken. LPA reviewed the facility sketch and confirmed that the home consists of three bedrooms and two bathrooms. Children in care have access to the living room, dining room, hallway bathroom, and backyard. All other rooms are made inaccessible with a baby gate and doorknob spinners. The backyard is fenced, free of hazards, and used for outdoor activities. LPA observed that the outdoor play area is partitioned by a wooden fence in the middle. On the north side of the backyard, LPA observed tricycles, an umbrella stand providing shade, an enclosed trampoline, and children’s furniture and toys. On the south side of the backyard, LPA observed a locked shed and a small dog. The licensee understands liability and responsibility for pets during child care hours. Licensee states there is no pool or bodies of water on the premises. Licensee also states there are no firearms or ammunition in the home. Detergents, cleaning compounds, medications, and other hazardous items are stored inaccessible to children. LPA observed age-appropriate furniture, toys, books, high chairs, and a play yards for children in the dining room. (Continue on LIC 809-C)

Cynthia Brannon
Xona Xayavong
	DATE: 09/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026

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

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)

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: RIOS DE GONZALEZ, ROSA FAMILY CHILD CARE	FACILITY NUMBER: 163911155
	VISIT DATE: 09/10/2026

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
26
27
28
29
30
31
32

Required postings are located on the parent board on the right side of the entry wall. The home has a functioning smoke detector, carbon monoxide detector, fire extinguisher, first aid kit, adequate heating/ventilation, and working telephone service. Fire clearance was granted on August 27, 2026, by the Hanford Fire Department.

Licensee reports the home is smoke-free. Licensee understands that children must be properly restrained when transported and that children cannot be left unattended in parked vehicles.

Children’s files were reviewed and found complete with required emergency information. Licensee completed Mandated Reporter Training on 4/18/2025. Licensee’s pediatric CPR/First Aid certification, completed through the American Red Cross, expires on 9/22/2027. Criminal record clearances/exemptions were verified, and the Guardian Roster was signed.

The family child care home capacity compliance sheet was reviewed with Licensee.

LPA discussed reporting requirements, safe sleep regulations, and provided the Safe Sleep webpage and CPSC recall information. For infants enrolled, LPA observed cribs and play yards free of loose items. Infants are not swaddled. Licensee provided documentation of 15-minute sleep checks for infants up to 24 months, and Individual Infant Sleeping Plans are completed for infants up to 12 months. Infants are placed on their backs to sleep.
Incidental Medical Services (IMS) were reviewed. LPA discussed medication storage, record requirements, and ADA resources. PIN 22-02-CCP information was provided.

LPA discussed the Community Care Licensing website, Quarterly Updates, PINs, inspection authority, and how to access forms at www.ccld.ca.gov. Licensee was reminded that all adults living or working in the home must have criminal record clearance or exemption prior to initial presence. Failure to meet this requirement results in civil penalties.

Licensee states hours of operation are Monday through Friday from 6:00 AM to 6:00 PM and as arranged. Licensee does not provide care for more than 24 hours. (Continue on LIC 809-C)

NAME OF LICENSING PROGRAM MANAGER: Cynthia Brannon
NAME OF LICENSING PROGRAM ANALYST: Xona Xayavong
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026

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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: RIOS DE GONZALEZ, ROSA FAMILY CHILD CARE	FACILITY NUMBER: 163911155
	VISIT DATE: 09/10/2026

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
26
27
28
29
30
31
32

Based on the inspection, the home meets the description of a safe and healthy environment for children and is adequate for licensure as a Large Family Child Care Home with a capacity of 14 children. Licensure as a Large Family Child Care Home will be recommended effective September 11, 2026.

An exit interview was conducted, and the report was reviewed with Licensee Rosa Rios De Gonzalez. The licensee was reminded to maintain the evaluation report for 3 years. The licensee confirmed there are no Registered Sex Offenders living on the premises, and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, no deficiencies are cited. Licensee was provided appeal rights. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit was provided and must remain posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Cynthia Brannon
NAME OF LICENSING PROGRAM ANALYST: Xona Xayavong
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2026

LIC809 (FAS) - (06/04)

Page: 4 of 4