243911965-2-14-2023-04-CC-JYAZ-CP2RME-20230214120836

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243911965
Report Date: 02/14/2023
Date Signed: 02/14/2023 12:08:48 PM

Document Has Been Signed on 02/14/2023 12:08 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	CAMPOS-ZAVALA, HEIDY FAMILY CHILD CARE		FACILITY NUMBER:	243911965
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	02/14/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Heidy Campos-Zavala		TIME COMPLETED:	12:15 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 02/14/2023, Licensing Program Analyst (LPA), Jeovanna Yanez met with Applicant, Heidy Campos-Zavala. for a pre-licensing inspection. Applicant, her husband, her adult son and one minor childr 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 or exemption. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: · This is a two story, three bedroom, two and a half bathroom home, and upstairs area will be off-limits to the day-care children. There is a gate at the bottom of the stairs making upstairs area inaccessible. Care and supervision will be provided in the mud room, classroom, kitchen, dining room and downstairs bathroom. There are two bedrooms and a living room downstairs that will be Off-Limits by use of plastic door knob covers and/or safety gate. · There is no fireplace in the home. · In the mudroom, LPA observed a parent board, children size furniture, games, toys, and books for the children. In the classroom, LPA observed a large alphabet carpet, learning wall art, books, games and safe toys for children. Children will nap in the classroom. Applicant does not plan on providing care to infants at this time. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. · Facility has 1A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. · Applicant’s Pediatric CPR and First Aid certification was completed through American Red Cross and expires on October 11, 2024. (CONTINUED ON 809-C)

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CAMPOS-ZAVALA, HEIDY FAMILY CHILD CARE	FACILITY NUMBER: 243911965
	VISIT DATE: 02/14/2023

NARRATIVE

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· Preventative Health and Safety with Prevention of Lead exposure certification was completed on November 9, 2022.
· Knives are stored in a bottom kitchen cabinet made inaccessible by a safety latch. Medications are stored in the off-limits laundry room, in a top cabinet. Cleaning compounds are stored in a bottom kitchen cabinet made inaccessible by a safety latch.
· 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 is an in-ground pool that is fenced with 6 ft. wooden planks, and another section of 4 and half ft. iron rod fencing, which does not meet Title 22 Regulations. Both sections of the fence swing into the pool. The gates are self-latching/self-closing and latching device is located no more than six inches from the top of the gate.
· There are two dogs that are kept in off-limit areas. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
· Firearms and ammunition are locked and stored separately in accordance with Title 22 Regulations.
· 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. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.
· Fenced sideyard has cement and sodded area for the children. There are safe toys for daycare children.
· SB 792 immunizations verified and on file.
· Applicant completed the Mandated Reporter Training on November 8, 2022.
· LPA discussed safe sleep regulations and Safe Sleep Concepts were given to applicant.
(CONTINUED ON 809-C)

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CAMPOS-ZAVALA, HEIDY FAMILY CHILD CARE	FACILITY NUMBER: 243911965
	VISIT DATE: 02/14/2023

NARRATIVE

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· 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 4:00 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 obtain a 2A10BC or bigger fire extinguisher.
· Applicant will make the two sections of the fence swing away from the pool, meeting Title 22 Regulations. LPA observed that the pool iron rod fencing height does not meet Title 22 Regulations. Applicant will ensure that the barricades to the in-ground pool meet Title 22 Regulations.

Pending verification of corrections of the above items and a final review of her application, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended.

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

LIC809 (FAS) - (06/04)

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