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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543906047
Report Date: 11/07/2022
Date Signed: 11/07/2022 02:42:51 PM

Document Has Been Signed on 11/07/2022 02:42 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:VELAZQUEZ, MARIA DEL FAMILY CHILD CAREFACILITY NUMBER:
543906047
ADMINISTRATOR:VELAZQUEZ, MARIA DELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 740-8209
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
11/07/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Maria Del Carmen VelazquezTIME COMPLETED:
03:00 PM
NARRATIVE
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On November 7, 2022 Licensing Program Analyst (LPA) Kari McWilliams conducted an unannounced case management inspection and met with Licensee Maria Del Carmen Velazquez. A tour of the facility was conducted and a census was taken.

During a complaint investigation completed by LPA McWilliams it was determined that adult #1 (A1) was not finger print cleared and was providing care and supervision to at least one child. Licensee provided LPA McWilliams with copies of the criminal record exemption paperwork confirming A1 was in the process of being finger printed and Licensee states that there was no other paperwork received after she sent in the exemption paperwork; causing Licensee to think A1 received clearance.

LPA McWilliams informed Licensee since A1 is not finger print cleared A1 cannot be in the facility when children are in care. Licensee will follow up on A1 finger prints and exemption process and confirmed A1 will not be in the facility during day care hours.

An exit interview was conducted with Licensee Maria Del Carmen Velazquez.



Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency isbeing cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

Upon receipt of a Type A violation, 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 was given to licensee.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Kari McWilliams
LICENSING EVALUATOR SIGNATURE: DATE: 11/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/07/2022
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 11/07/2022 02:42 PM - It Cannot Be Edited


Created By: Kari McWilliams On 11/07/2022 at 02:02 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: VELAZQUEZ, MARIA DEL FAMILY CHILD CARE
FACILITY NUMBER: 543906047

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/07/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/07/2022
Section Cited
CCR
102416

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(d) Prior to employment or initial presence in the child care home, all employees and volunteers subject to a criminal record review shall:(1)Obtain a California clearance or a criminal record exemption as required by law or Department regulations.
This requirement was not met by evidenced
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A1 is currently not at facility and mostly works out of town during the week. Licensee stated that she will follow up on the exemption process that was never completed and A1 will not be at the facility until exemption process is completed.
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through record review that showed A1 did not have a criminal record clearance and was present at the child care facility.
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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:Kari McWilliams
LICENSING EVALUATOR SIGNATURE:
DATE: 11/07/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/07/2022


LIC809 (FAS) - (06/04)
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