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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503912153
Report Date: 06/27/2025
Date Signed: 06/27/2025 02:00:48 PM

Document Has Been Signed on 06/27/2025 02:00 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:MARTINEZ BARBA, ANA FAMILY CHILD CAREFACILITY NUMBER:
503912153
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
06/27/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Licensee Ana Martinez BarbaTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Aurelio Mendoza conducted an unannounced annual/random inspection and was greeted by Licensee Ana Martinez Barba. The licensee is Spanish-speaking, and LPA assisted with interpretation throughout the visit. The licensee currently provides daycare services Monday through Saturday, 24 hours a day.

LPA toured the home both inside and outside. A census was taken, and the facility sketch was reviewed. During the walkthrough, LPA confirmed that only the second living room and the hallway bathroom on the first level of the home were currently being used for child care. All other areas were off-limits and made inaccessible using child safety gates and doorknob covers.

During today's visit, the licensee requested that the first living room also be approved for child care use. LPA inspected the first living room, found it to be in compliance, and approved it for use immediately. A copy of the facility sketch was updated during the visit, and both LPA Aurelio Mendoza and Licensee Ana Martinez Barba initialed the updated sketch to acknowledge approval of the new child care area.

The licensee also requested that the backyard area be inspected for use by children in care. However, the area was not approved at this time because a section of the fence requires repair to meet safety standards. LPA Aurelio Mendoza directed the licensee to contact the officer of the day and/or to reach out directly to LPA Aurelio Mendoza once the backyard fence has been repaired, so that an inspection can be performed. If the area is found to be in compliance with Title 22 regulations, it may be approved for child care use at that time.

The licensee has one small dog and one cat, both of which remain outside the home. Per the licensee, the pets do not have contact with the children during daycare hours. LPA reminded the licensee that she is responsible for her pets’ actions in the event of any incident involving the children.

NAME OF LICENSING PROGRAM MANAGER: Joseph Pacheco
NAME OF LICENSING PROGRAM ANALYST: Aurelio Mendoza
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2025
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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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: MARTINEZ BARBA, ANA FAMILY CHILD CARE
FACILITY NUMBER: 503912153
VISIT DATE: 06/27/2025
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There are no swimming pools or other bodies of water on the premises. LPA discussed the new pool safety requirements under Assembly Bill (AB) 2866, which went into effect on January 1, 2025. LPA referenced Provider Information Notice (PIN) 25-01-CCP, issued on January 6, 2025, and directed the licensee to review the PIN for more information. Additional resources are available at www.ccld.ca.gov.

No firearms or ammunition were observed on the premises. All poisons are kept in locked storage, and none were visible during the inspection. Hazardous items such as detergents, cleaning supplies, and medications were stored out of children's reach.

The home is a two-story, four-bedroom, two-and-a-half-bathroom residence. The upstairs area is off-limits to daycare children and secured with a child safety gate at the base of the stairs. All off-limit rooms were observed to be properly secured with child safety measures. There is a fireplace in the second living room, which the licensee stated is not used during daycare hours. The fireplace is barricaded with glass and metal doors to prevent access by children.

The home is equipped with a functioning smoke detector, carbon monoxide detector, a fully charged fire extinguisher, and adequate heating and ventilation. A working telephone line is available, and the phone number (510) 674-3025 was verified.

The licensee confirmed that children are supervised at all times and understands that children are never to be left in parked vehicles. Although the outdoor play area was toured, it was not approved for use due to the fence condition, as noted above.

LPA reviewed a sample of children’s files and found them complete, including emergency contact information. The licensee’s Mandated Reporter Training is current through April 2, 2027. Pediatric CPR and First Aid certification is valid through December 7, 2026. Records reviewed indicate that all employees and/or volunteers have immunization documentation on file for influenza, pertussis, and measles.

LPA discussed the Community Care Licensing Division website, www.ccld.ca.gov, which provides access to forms, regulations, Provider Information Notices (PINs), and quarterly updates. Reporting requirements, per Section 102416.2, were reviewed with the licensee.

LPA reminded the licensee that all adults aged 18 and over who live or work in the home—including volunteers—must have a criminal record clearance or exemption before being present at the facility, as required by Health and Safety Code section 1596.871. A civil penalty of $100 per day (up to 5 days, or 30 days for repeat violations) may be assessed for noncompliance with this requirement.

NAME OF LICENSING PROGRAM MANAGER: Joseph Pacheco
NAME OF LICENSING PROGRAM ANALYST: Aurelio Mendoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
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: MARTINEZ BARBA, ANA FAMILY CHILD CARE
FACILITY NUMBER: 503912153
VISIT DATE: 06/27/2025
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Safe sleep regulations were discussed. LPA provided information on the Child Care Licensing Safe Sleep webpage:
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep

The licensee was advised to regularly check the U.S. Consumer Product Safety Commission (CPSC) website:
https://www.cpsc.gov/
and to register all infant products to receive safety recall notifications.

The Incidental Medical Services (IMS) policy was discussed. If IMS is provided, a Plan for Providing IMS must be submitted to the Department. For more information, the licensee was referred to PIN 22-02-CCP. ADA-related resources were also shared, including the U.S. Department of Justice’s toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY), and the publication:
https://www.ada.gov/resources/child-care-centers/

Information was provided regarding MyChildCarePlan.org, a public website designed to help families find child care providers across California and connect with local Resource and Referral Agencies (R&Rs).

An exit interview was conducted, and the report was reviewed with Licensee Ana Martinez Barba. The licensee confirmed that there are no registered sex offenders residing in the home. LPA verified the RSO profile in FAS.

No deficiencies were cited today in accordance with Title 22, Division 12 of the California Code of Regulations.

Licensee Ana Martinez Barba was provided a copy of her Appeal Rights.

A LIC 9213 – Notice of Site Visit was issued and must remain posted for 30 days. This report shall be made available to the public upon request.

NAME OF LICENSING PROGRAM MANAGER: Joseph Pacheco
NAME OF LICENSING PROGRAM ANALYST: Aurelio Mendoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2025
LIC809 (FAS) - (06/04)
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