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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 165620417
Report Date: 03/18/2024
Date Signed: 04/08/2024 10:06:39 AM

Document Has Been Signed on 04/08/2024 10:06 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:RAMIREZ, EVA FAMILY CHILD CAREFACILITY NUMBER:
165620417
ADMINISTRATOR:RAMIREZ, EVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 852-7711
CITY:LEMOORESTATE: CAZIP CODE:
93245
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
03/18/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:49 AM
MET WITH:Eve RodiguezTIME COMPLETED:
12:00 PM
NARRATIVE
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On March 18, 2023, Licensing Program Analyst (LPA) Paul Garcia and Investigator Rippe conducted an unannounced case management visit and met with Licensee Eva Ramirez. A tour of the facility was given, and a census was taken. Three infants were in care at the time of the visit. While LPA was reviewing facility files LPA observed that the licensee failed to produce any safe sleep logs for the children in care nor any archived logs. When LPA asked Licensee why she has failed to or attempted to complete this required action, she stated, “I have not done them.” LPA reminded Licensee that as a condition of her licensee it is required to be aware and follow safe sleep regulations. LPA provided the following assistance.

There is to be one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider is to physically perform checks on sleeping infants every fifteen minutes and document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness, and labored breathing. Licensee is to ensure Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is to be completed and in a file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Per the California Code of Regulations, Title 22, Division 12, Chapter 3, the following deficiency is being cited during today’s inspection. (See next page, LIC809-D).



Report was reviewed and exit interview was conducted with Eva Ramirez.

A Notice of Site was provided and must be posted for thirty days.

SUPERVISORS NAME: Gloria Reyes
LICENSING EVALUATOR NAME: Paul Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2024
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 2
Document Has Been Signed on 04/08/2024 10:07 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 04/04/2024 11:01 AM


Created By: Paul Garcia On 03/18/2024 at 11:07 AM
Link to Parent Document Below:
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: RAMIREZ, EVA FAMILY CHILD CARE
FACILITY NUMBER: 165620417

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/18/2024
Section Cited
CCR
102425(e)(j)(1)

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102425 INFANT SAFE SLEEP
The provider shall supervise infants while they are sleeping and adhere to the following requirements:

(1) The provider shall physically check on the infant every 15 minutes.
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Licensee shall immediately start conducting 15 minutet checks on children 2 years of age or younger when they are sleeping. Licensee shall send LPA weekly proof that the checks are being conducted every Friday before (EOD) end of business day for the
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Based on observation and record review, and self-disclosure, the licensee failed to conduct 15 minute checks ... which has a potential Health and Safety and Personal Rights risk to persons in care.
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duration of two (2) months from the day of this citation. (End date Friday, May 17, 2024)

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Gloria Reyes
LICENSING EVALUATOR NAME:Paul Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 03/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2024


LIC809 (FAS) - (06/04)
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