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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543802572
Report Date: 08/03/2023
Date Signed: 08/03/2023 12:26:58 PM

Document Has Been Signed on 08/03/2023 12:26 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:WATERS FAMILY CHILD CAREFACILITY NUMBER:
543802572
ADMINISTRATOR:WATERS, SHARONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 734-1239
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
08/03/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Sharon WatersTIME COMPLETED:
12:45 PM
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On 8/3/2023, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced Required 1 year inspection and met with Licensee Sharon Waters. Licensees spouse James Waters and grandson Brent Doughterty were also present. A tour of the home was conducted, and a census was taken. Current facility sketch reviewed, and Licensee confirmed living room, the playroom, bedroom #1 and #3 and the hall bathroom are used for providing care and are accessible to day care children. All other rooms are off-limits and are made inaccessible by use of safety gates.
Hours of operation are Monday through Friday 7:15 AM to 4:30 PM and other hours as arranged. This is a single level home and there are no stairs. Safe toys and play equipment are observed.

Medications and other hazardous items were inaccessible to children. LPA did not observe any poisons in the home. Poisons were locked per regulation. The fire extinguishers, smoke detectors, and carbon monoxide detector met Community Care Licensing (CCL) regulations. Heating/cooling and ventilation was sufficient for safety and comfort. Adequate supervision was being provided during this inspection.

LPA discussed the safe sleep regulations with licensee Waters and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Waters of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The outdoor play area in the backyard is fenced. Licensee ensures that children in care are supervised at all times. Licensee has no pets at this home. There were no swimming pools, bodies of water on the premises. Firearms and ammunition were properly stored and locked separately. Continued on LIC809-C
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE: DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/03/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: WATERS FAMILY CHILD CARE
FACILITY NUMBER: 543802572
VISIT DATE: 08/03/2023
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A sample of children’s records contained all emergency information specified by regulation. A review of records indicated Licensee has proof of required immunization (Pertussis/Measles/Influenza) and/or written declaration declining flu shot. Licensee's Mandated Reporter Training was completed on 6/19/2023. Licensee's pediatric CPR and First Aid expires on 2/24/2024.
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Sharon Waters was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms, and Regulations.

Licensee Waters was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Continued on LIC809-C
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2023
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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: WATERS FAMILY CHILD CARE
FACILITY NUMBER: 543802572
VISIT DATE: 08/03/2023
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Exit interview conducted and report was reviewed with Sharon Waters. During the exit interview, Waters confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.
Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited. Licensee Waters was provided a copy of Licensee Appeal Rights.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2023
LIC809 (FAS) - (06/04)
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