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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243911965
Report Date: 06/25/2025
Date Signed: 06/25/2025 10:49:02 AM

Document Has Been Signed on 06/25/2025 10:49 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CAMPOS-ZAVALA, HEIDY FAMILY CHILD CAREFACILITY NUMBER:
243911965
ADMINISTRATOR/
DIRECTOR:		CAMPOS-ZAVALA, HEIDYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 241-6393
CITY:MERCEDSTATE: CAZIP CODE:
95340
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
06/25/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Heidy Campos-ZavalaTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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On June 25, 2025, Licensing Program Analysts (LPAs) Pa Kou Vue and Miguel Herrera conducted an unannounced case management inspection. LPAs were greeted by Licensee, Heidy Campos-Zavala. Present during today's inspection were 11 children with licensee and an assistant. The purpose of today's inspection was to inspect an in-ground pool fence that was recently modified to ensure it meets Title 22 Regulations.

During today's inspection, LPAs inspected an in-ground pool located in the backyard yard that is enclosed with a five (5) foot wrought iron fencing. There is a gate that is self-latching/self-closing, swings away from the pool and the key locking device is located no lower than 60 inches from the bottom of the gate. The maximum vertical clearance was measured less than 2 inches. The spacing between the iron slats measure no more than 4 inches in width in separation to the next slat.

There is a life ring with US Coast Guard Approval that has an exterior diameter measured at 20 inches, a rescue pole with a body hook that measured over 12 feet, and a daily inspection log. There is also a pool alarm that is functioning when placed in the body of water and is compliant with ASTM International Standard F2208. The in-ground pool is in accordance with Title 22 Regulations. LPAs advised Licensee Campos-Zavala to regularly maintain the pool fence/pool gate as weather, and normal wear and tear can degrade the pool fence/gates. Licensee is aware of child safety around the pool and assumes all responsibility and understood the responsibility of maintaining the pool fence/gates and pool equipment. Licensee stated that the backyard will continue to remain off limits to children in care as the facility uses the fenced front yard for outside play.

The pool fencing meets Title 22 regulations and Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, no deficiencies were observed during today's inspection. Exit interview conducted with Licensee Campos-Zavala. A notice of site visit (LIC 9213) was given and must remain posted for 30 days. Appeal rights were also provided.

NAME OF LICENSING PROGRAM MANAGER: Juvenal Moctezuma
NAME OF LICENSING PROGRAM ANALYST: Pa Kou Vue
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/25/2025
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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