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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503903750
Report Date: 03/15/2024
Date Signed: 03/15/2024 05:39:13 PM

Document Has Been Signed on 03/15/2024 05:39 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:GUEVARA, OFELIA FAMILY CHILD CAREFACILITY NUMBER:
503903750
ADMINISTRATOR:GUEVARA, OFELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 894-7863
CITY:PATTERSONSTATE: CAZIP CODE:
95363
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
03/15/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:Ofelia GuevaraTIME COMPLETED:
06:00 PM
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On 03/14/2024 Licensing Program Analysts (LPAs) Anita Tristan and Stephanie Vega-Gonzalez conducted an unannounced Required Case Management Inspection. LPAs met with Licensee, Ofelia Guevara. LPAs took a census and toured the facility, inside and outside. LPAs observed 2 children eating snack and one child playing in front day care area.

During today’s inspection upon arrival LPAs observed a adult one in the kitchen; visiting from Mexico. LPAs observed a bucket of water placed outside in the back yard by the back glass sliding door. Licensee poured water out. LPAs observed a cat litter box that was open in the kitchen area where it was accessible to children in care with cat feces. LPAs observed the baby gate that was at the bottom of the stairs was easily removed and fall over making the stairs and upstairs area accessible to children in care. LPAs observed several bottles of medication and Vicks on the kitchen island accessible to children.

Exit interview conducted and report was reviewed with Licensee, Ofelia Guevara.
Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: A type A violation was issued on todays date along with a civil penalty. Appeal Rights were provided and discussed.

Upon receipt of a Type A violation, the licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 Acknowledgement of Receipt of Licensing Reports was given to Licensee, Ofelia Guevara.
LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Anita Tristan
LICENSING EVALUATOR SIGNATURE: DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/15/2024
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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Document Has Been Signed on 03/15/2024 05:39 PM - It Cannot Be Edited


Created By: Anita Tristan On 03/15/2024 at 05:12 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GUEVARA, OFELIA FAMILY CHILD CARE
FACILITY NUMBER: 503903750

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/16/2024
Section Cited
CCR
102370(a)

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102370-Criminal Record Clearance (a)Prior to the Department issuing a license, the applicant(s) and all adults residing in the home shall obtain a California criminal record clearance or exemption.
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Licensee stated that she will provide a written statement stating the following: 1. Uncleared adults will not be in the home while children are in care. 2. Licensee will communicate with the department.
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This requirement was not met as evidence by: LPAs observed an uncleared adult in the home. This poses an immidiate risk to the health and safety to children in care.
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And lastly, licensee stated she will include a future plan of actions on how she will ensure Adult 1 will not be in the home while children are in care.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Cynthia Brannon
LICENSING EVALUATOR NAME:Anita Tristan
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2024


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Document Has Been Signed on 03/15/2024 05:39 PM - It Cannot Be Edited


Created By: Anita Tristan On 03/15/2024 at 05:21 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GUEVARA, OFELIA FAMILY CHILD CARE
FACILITY NUMBER: 503903750

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/29/2024
Section Cited
CCR
102417(g)

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102417 Operation of a Family Child Care Home (g)The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: This requirement was
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Licensee stated that she will ensure that the stairs that leads to the second floor in the home has a functional gate and area is made inaccessible to children in care. Licensee stated that she will make
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not met as evidence by: LPAs observed an open cat litter with cat feces, medication on the counter, and a broken baby gate that made the upstairs accessible to children in care. This poses a potential health and safety risk to children in care.
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cat litter inaccessible to children in care. Licensee stated that she will write a statement on how she will keep medications in an inaccessible area. Licensee stated she will provide proof to the department by 3/29/2024.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Cynthia Brannon
LICENSING EVALUATOR NAME:Anita Tristan
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2024


LIC809 (FAS) - (06/04)
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