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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503911966
Report Date: 06/22/2026
Date Signed: 06/22/2026 12:46:37 PM

Document Has Been Signed on 06/22/2026 12:46 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:SEGURA, ADRIANA FAMILY CHILD CAREFACILITY NUMBER:
503911966
ADMINISTRATOR/
DIRECTOR:		SEGURA, ADRIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 319-6136
CITY:PATTERSONSTATE: CAZIP CODE:
95363
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
06/22/2026
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:15 AM
MET WITH:Adriana SeguraTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On 06/22/2026, Licensing Program Analyst (LPA) Kimberly Vass and Licensing Program Manager (LPM) Jose Penate conducted a case management inspection at Licensee's request to make the living room and dining room accessible to children in care. LPA Vass and LPM Penate met with Adrianna Segura and conducted a tour of the facility and a census was taken. Also present during inspection was licensee's assistant.

LPA and LPM inspected the living room and dining room. The kitchen is made inaccessible by safety gates. LPA and LPM observed the laundry room door is made inaccessible by a child safety door latch. LPA and LPM observed a hallway leading to bedrooms not used for daycare that needs to be made inaccessible. LPA and LPM observed a safety gate barricading the living room which needs to be removed due to area being utilized for daycare children to walk through in order to access the backyard. LPA and LPM toured the backyard where children were present and observed the backyard to have chicken wire fencing with sharp pointed parts that was used for a dog enclosure, also air conditioning unit having sharp pointed chicken wire exposed that is a danger to children in care. Furthermore, LPA and LPM observed animal feces on the side pathway of the home that is used to house the dogs and was accessible to children in care.

Licensee stated she cares for her mom's two dogs during daycare hours. Licensee understands any responsibility of actions taken by pets involving children in care.

NAME OF LICENSING PROGRAM MANAGER: Jose Penate
NAME OF LICENSING PROGRAM ANALYST: Kimberly Vass
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/22/2026
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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Document Has Been Signed on 06/22/2026 12:46 PM - It Cannot Be Edited


Created By: Kimberly Vass On 06/22/2026 at 11:17 AM
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: SEGURA, ADRIANA FAMILY CHILD CARE
FACILITY NUMBER: 503911966

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/22/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/06/2026
Section Cited
CCR
102417(g)

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(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to..
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Licensee stated that she will remove the sharp pointed chicken wire, and make the air conditioning unit inaccessible. Licensee will provide photograph of chicken wire removal by POC date of 7/6/26. Licensee will remove animal feces by close of business today.
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This requirement is not met as evidenced by:
Based on LPA's and LPM's observation, the licensee did not comply with the section cited above as today LPA and LPM observed backyard to have chicken wire fencing with sharp pointed parts exposed barracading the air conditioning unit and the perimeter of the yard. Animal feces were observed in the backyard that was accessible to children in care. This poses a potential health, safety or personal rights risk to persons 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.
Jose Penate
NAME OF LICENSING PROGRAM MANAGER:
Kimberly Vass
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/22/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/22/2026


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: SEGURA, ADRIANA FAMILY CHILD CARE
FACILITY NUMBER: 503911966
VISIT DATE: 06/22/2026
NARRATIVE
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An updated facility sketch was requested from licensee during today’s inspection. Due to the ongoing repairs needing to be finalized, LPA did not approve the living room or dining room for use at this time. Licensee understands to continue to make the rooms off-limits until CCLD Fresno approves the rooms for day-care use. LPA will follow up once all repairs are completed to be able to utilize for daycare use.

Per Title 22, Division 12, of the California Code of Regulations, the following deficiency is being cited: (see next page).

Licensee was provided appeal rights.

Exit interview conducted with Licensee Adrianna Segura and a copy of this report was provided.

A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Jose Penate
NAME OF LICENSING PROGRAM ANALYST: Kimberly Vass
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2026
LIC809 (FAS) - (06/04)
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