165621091-5-20-2026-57-CC-NLOI-DU9NXZ-20260520105159

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 165621091
Report Date: 05/20/2026
Date Signed: 05/20/2026 10:52:18 AM

Document Has Been Signed on 05/20/2026 10:52 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:	QUINN, SAMANTHA FAMILY CHILD CARE		FACILITY NUMBER:	165621091
ADMINISTRATOR/ DIRECTOR:	QUINN, SAMANTHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 309-2381
CITY:	HANFORD	STATE: CA	ZIP CODE:	93230
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/20/2026
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Samantha Quinn		TIME VISIT/ INSPECTION COMPLETED:	11:00 AM

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 5/20/2026, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Samantha Quinn for a pre-licensing inspection. Applicant, her husband, her adult brother in law and three 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 4/29/2026. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: Fire clearance was received on 5/19/2026. Fire pull alarm is located in the home’s dining room wall. This is a two story, four bedroom and three bathrooms home and a basement. The upstairs area will be off-limits to the day-care children. There is a gate at the bottom of the stairs and a child proof doorknob cover on the door that leads to the upstairs area making upstairs area inaccessible. Care and supervision will be provided in the living room, family room (day care room), kitchen, dining room and downstairs half bathroom. Off-limits rooms/ closets are made inaccessible by use of child proof doorknob covers and hook and eye locks. There is a fireplace in the living room that applicant states it will not be used during day-care hours. There is central air heating/cooling ventilation for safety and comfort. (Continued on LIC809-C):

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Norma Lomeli
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

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: QUINN, SAMANTHA FAMILY CHILD CARE	FACILITY NUMBER: 165621091
	VISIT DATE: 05/20/2026

NARRATIVE

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LPA observed in the day care room, child size furniture, safe toys, books and arts and crafts supplies for the children. There is an infant swing in the day care room. LPA did not observe a parents board. Applicant states she will post her licensing documents on the sliding glass door located in the day care room. There is a diaper changing station near the downstairs half bathroom. There are four booster feeding chairs in the dining room.
LPA advised applicant the parents board must be readily available for parents to view. Children will nap in the day care room and living 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 in the kitchen. 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 American Heart Association and expires on 2/4/2028. Applicant does not have a qualified assistant. Applicant understands per Title 22 Regulations she must have a qualified assistant when she operates her family child care home as a large capacity.
Preventative Health and Safety with Nutrition and Prevention of Lead exposure certification was completed on 3/18/2026.
Applicant completed the Mandated Reporter Training on 2/4/2026.
Knives are stored inside a top kitchen cabinet. Medications are stored inside a top kitchen cabinet and in the upstairs bathroom. Cleaning compounds are stored inside the cabinet that is located underneath the kitchen sink and made inaccessible by the use of cabinet child safety latch. Other cleaning compounds are stored in the inaccessible basement.
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.
Effective 01/01/2025, all childcare facilities licensed by CCL by law will be required to adhere to AB2866 -

(Continued on LIC809-C):

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Norma Lomeli
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

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: QUINN, SAMANTHA FAMILY CHILD CARE	FACILITY NUMBER: 165621091
	VISIT DATE: 05/20/2026

NARRATIVE

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The Pool Safety Act. According to Health & Safety Code 1596.814, additional safety features will be required. There is an in-ground pool that is fenced with mesh fencing in compliant with American Society for Testing Materials (ASTM) International Standard F2286 in accordance with Title 22 Regulations.
The gate is self-latching/self-closing, swings away from the pool and key lockable device is located no lower than 60 inches above the ground.
Applicant has an alarm that is placed in the swimming pool and sounds upon detecting an entrance into the water, alarm meets ASTM International Standard F2208. Applicant tested alarm with LPA during today's inspection.
Applicant has a life ring diameter of 20 inches, approved by the US Coast Guard. LPA observed the life ring mounted inside the pool area.
Applicant has a rescue pole with a body hook and it is at a fixed length of 12 feet. LPA observed the rescue pole mounted inside the pool area.
Applicant shall perform a daily inspection of the safety features and equipment before opening the facility and maintain a log of the inspections to be provided to the Department upon request. LPA provided applicant with an example of bodies of water daily inspection checklist.
There are two dogs and a tortoise that are kept 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 or ammunition in the home or premises. Poisons are stored key locked inside the detached garage.
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 not be transporting 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: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

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: QUINN, SAMANTHA FAMILY CHILD CARE	FACILITY NUMBER: 165621091
	VISIT DATE: 05/20/2026

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Fenced backyard has a cemented and sodded yard for the children. LPA observed Step 2 safe toys, two water play tables, a Kid Craft playhouse, and two picnic benches.
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 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 “Receive Important Updates” and register to PIN.
Pending a final review of application file, licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended effective 5/21/2026.

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Norma Lomeli
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026

LIC809 (FAS) - (06/04)

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