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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203807576
Report Date: 11/13/2024
Date Signed: 11/13/2024 01:59:14 PM

Document Has Been Signed on 11/13/2024 01:59 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MEDINA, MARIBEL FAMILY CHILD CAREFACILITY NUMBER:
203807576
ADMINISTRATOR/
DIRECTOR:
MEDINA, MARIBELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 664-1568
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 3DATE:
11/13/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Maribel MedinaTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 11/13/2024 Licensing Program Analyst (LPA), Yesenia Fierro conducted an unannounced Annual Required Inspection and was met by Licensee, Maribel Medina. LPA explained the reason for the visit. LPA Fierro confirmed the home has a working telephone service. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Licensee stated she is open 24/7 but currently does not have any children enrolled needing such hours. Currently Licensee stated her days and hours of operation are Monday through Sunday from 5:00a.m.-5:00p.m. Licensee stated there are no firearms or ammunition on the premises. There are no pets in the home or bodies of waters.

LPA conducted a census, during today’s inspection there were 3 children present in the home, capacity as specified on the license is being maintained. A current facility sketch was reviewed, and Licensee confirmed that the kitchen, bathroom, dining room, living room, and daycare room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of door spinners and baby gates.

During today’s inspection LPA toured the home inside and outside. This is a single-story home. The fireplace located in the living room is made inaccessible by a screen and home furnishing piece. Licensee stated that fireplace will not be in use during daycare hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. LPA observed licensee test the smoke detector and carbon monoxide. Licensee understands to test both smoke detector and carbon monoxide periodically for functionality.

During today’s inspection LPA observed areas, surfaces, carpets, and floors accessible to the children are in operable and sanitary condition. LPA observed the home to have age-appropriate toys, dramatic play equipment, and learning materials. Licensee stated that all poisons are kept inside a cabinet that remains

SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE: DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/13/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MEDINA, MARIBEL FAMILY CHILD CARE
FACILITY NUMBER: 203807576
VISIT DATE: 11/13/2024
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locked and inside the storage shed in the backyard. LPA did not observe any poisons during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

LPA observed the outdoor play area in the backyard is fenced and there are no hazards to children present. LPA did not observe a swimming pool or other bodies of water on the premises, and Licensee stated that here are no swimming pool or other bodies of water. LPA observed age-appropriate toys, dramatic play equipment, and playground set for the use of children. Licensee has a current roster of the children. An emergency fire/disaster drill has been completed and documented within the last 6 months. Licensee’s Mandated Reporter Training was completed on 09/24/2026. Licensee’s pediatric CPR/First Aid expires on 06/3/2025. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis, and measles.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

Licensee stated she is caring for infants. LPA observed 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. License stated that infants are not swaddled while in care. Licensee physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment

SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MEDINA, MARIBEL FAMILY CHILD CARE
FACILITY NUMBER: 203807576
VISIT DATE: 11/13/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE Maribel Medina, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.



Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Maribel Medina.

SUPERVISORS NAME: Kari McWilliams
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
LIC809 (FAS) - (06/04)
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