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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543807108
Report Date: 12/13/2024
Date Signed: 12/13/2024 10:59:31 AM

Document Has Been Signed on 12/13/2024 10:59 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 SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:GUTIERREZ, ESTHELA FAMILY CHILD CAREFACILITY NUMBER:
543807108
ADMINISTRATOR/
DIRECTOR:		GUTIERREZ, ESTHELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 409-3189
CITY:IVANHOESTATE: CAZIP CODE:
93235
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
12/13/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:05 AM
MET WITH:Esthela GutieerezTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
NARRATIVE
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On 12/13/2024, a case management inspection was conducted by Licensing Program Analyst (LPA) Nohemi Sanchez. LPA met with Licensee Esthela Gutierrez to discuss an incident report submitted to Community Care Licensing regarding an incident that occurred on 11/21/2024.

Licensee is Spanish-speaking, and LPA provided interpretation. The licensee stated that on the date of the incident she had taken two children in care.

While outside licensee stated that Child #1 was playing with a sun damage toy lawn mower and Child #1 hit his face with the toy. The plastic toy was broken/cracked with exposed sharp edges. This caused Child #1 to have a small injury on the bottom of their right eye causing a small cut to the eye. Licensee reported that he had minimal bleeding, licensee reported cleaning it and sanitizing the injury. Licensee provided child ice pack. Licensee stated that child was not taken to the doctor and was in care the next day.

Licensee stated that Child’s parent was notified upon pick up time. Licensee immediately discarded the damage toy.

Exit interview conducted with Licensee, Esthela Gutierrez.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see LIC 809-D).

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Nohemi Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2024
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 12/13/2024 10:59 AM - It Cannot Be Edited


Created By: Nohemi Sanchez On 12/13/2024 at 10:36 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: GUTIERREZ, ESTHELA FAMILY CHILD CARE
FACILITY NUMBER: 543807108

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/27/2024
Section Cited
CCR
102417(d)

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Operation of a Family Child Care Home….The home shall provide safe toys, play equipment and materials.

This Requirement was not met as evidence by:
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Licensee discarded toy immediately. Licensee stated that ....all unsafe toys will be removed immediately. Licensee shall submit written plan to remove unsafe toys to CCL by 12/27/2024.
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Based on interviews and record reviewed licensee failed to remove unsafe toys from home. Which caused injury to child.
This poses a potential risk to the health, safety or personal rights of children.
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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:Luisa Gavoutian
LICENSING EVALUATOR NAME:Nohemi Sanchez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2024


LIC809 (FAS) - (06/04)
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