243911965-5-22-2025-04-CC-MHEA-DGWQES-20250522120650

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243911965
Report Date: 05/22/2025
Date Signed: 05/22/2025 12:07:07 PM

Document Has Been Signed on 05/22/2025 12:07 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:	CAMPOS-ZAVALA, HEIDY FAMILY CHILD CARE		FACILITY NUMBER:	243911965
ADMINISTRATOR/ DIRECTOR:	CAMPOS-ZAVALA, HEIDY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 241-6393
CITY:	MERCED	STATE: CA	ZIP CODE:	95340
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 12	DATE:	05/22/2025
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:45 AM
MET WITH:	Heidy Campos-Zavala		TIME VISIT/ INSPECTION COMPLETED:	12:20 PM

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On 05/22/2025, Licensing Program Analysts (LPAs) Miguel Herrera and Pa Kou Vue conducted an unannounced Case Management-Licensee Initiated inspection. LPAs met with Licensee Heidy Campos-Zavala, who accompanied LPAs during a tour of the facility both inside and outside. During the inspection licensee’s husband and assistant were present. LPAs explained the purpose for the inspection and a census was taken.

The reason for the inspection was to review modifications that were made to the home. Licensee Campos-Zavala recently removed a raised bed and modified the fence in the backyard. LPAs inspected the backyard and observed that the backyard fence was modified, and a raised bed was removed. The children’s outdoor play area is in the front yard, which is fenced and in compliance. The children do not have access to the side or back yard as they are made inaccessible by a locked sliding door and there is a baby gate that separates the off-limits living room and the accessible kitchen that is used for day-care purposes. The backyard has a built-in swimming pool in the backyard which is fenced and made inaccessible.

Licensee Campos- Zavala disclosed that the facility would also be installing a new pool fence and would contact LPAs to inspect the fence once it was completed to ensure it met AB2866 – Pool Safety regulations. LPA inspected the pool fence and discussed and reviewed AB 2866 – Pool Safety Regulations with licensee’s husband and Licensee Campos-Zavala. Licensee Campos-Zavala stated that she understood and will adhere to AB 2866 – Pool Safety regulations. Licensee Campos-Zavala stated that the pool fence would be completed by 06/05/2025.

LPA observed a hot tub located in the backyard. The hot tub cover is locked in all four corners and is in good repair. LPA Herrera advised Licensee to regularly maintain the hot tub cover as weather, and normal wear and tear can degrade the hot tub cover.

Exit interview conducted and report was reviewed with Licensee Heidy Campos-Zavala. Per the California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency has been cited during today’s inspection. Licensee Heidy Campos -Zavala was provided a copy of Appeal Rights. A Notice of Site Visit was given and must remain posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Juvenal Moctezuma
NAME OF LICENSING PROGRAM ANALYST: Miguel Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025

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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