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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543911187
Report Date: 02/26/2025
Date Signed: 02/26/2025 05:33:25 PM

Document Has Been Signed on 02/26/2025 05:33 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:MARTINEZ-LOMELI, ISABEL FAMILY CHILD CAREFACILITY NUMBER:
543911187
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
02/26/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Isabel Martinez-LomeliTIME VISIT/
INSPECTION COMPLETED:
05:45 PM
NARRATIVE
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An unannounced Case Management visit was conducted by Licensing Program Analysts (LPAs) Sonja Navarrette and Lady Cabrera. LPAs toured the home inside and outside and a census was taken. LPA reviewed current facility sketch and confirmed that the kitchen, bathroom, dining room and living room are used for providing care and are accessible to children.

The purpose of the inspection was to review personal right regulations and review children files. LPAs reviewed a sample of children’s files and observed files were not complete as required. Based on records reviewed and interview, two infants present did not have documentation of the 15-minutes checks. According to Licensee, she conducts the 15-minute checks, but did not know what form she had to complete. Five out of five children files were missing the Consent for Emergency Medical Treatment (LIC627) forms, and three of the five children present did not have the CDPH/PM286 on file. LPAs provided a copy of 102423 Personal Rights regulations.

During the outside tour, Licensee stated backyard is inaccessible and reported there was an empty in-ground pool. LPA Cabrera requested to see the swimming pool. LPAs observed a swimming pool was fenced per regulation with a gate that is self-latching, self-closing, and opens away from the swimming pool. However, there was a large opening on the metal fenced in the east side of the backyard.

According to Licensee, Adult 1 built a doghouse and removed the metal fence. Adult 1 and Licensee reported they have been working on the doghouse since the last week. Master bedroom has direct window to the pool. Upon arrival, LPAs observed master bedroom with a doorknob spinner and was not fully closed. Per facility sketch, master bedroom is an inaccessible room. LPA went over the regulation. During the pool inspection, LPAs observed mesh tarp, which is not a pool cover. LPA requested Licensee to remove tarp. LPAs observed more than 7 inches of accumulated rainwater in the shallow area. Pool has a jacuzzi built within the pool as well. LPA requested for water to be drain, however, they did not have a water pump hose. Licensee stated she will purchase water pump hose by today to drain the accumulated rainwater.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE: DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/26/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
Document Has Been Signed on 02/26/2025 05:33 PM - It Cannot Be Edited


Created By: Lady Cabrera On 02/26/2025 at 02:58 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: MARTINEZ-LOMELI, ISABEL FAMILY CHILD CARE
FACILITY NUMBER: 543911187

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/12/2025
Section Cited
CCR
102417(g)(7)

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An emergency...shall be maintained for each child ...and the parent's authorization for the licensee or registrant to consent to emergency medical care.

This requirement is not met as evidenced by:
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Licensee stated she will have parents complete all required LIC627 and will provide pictures to CCL of completed forms by 03/12/2025.

LPA provided blank LIC627 form to Licensee.
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Based on record review, the licensee did not comply with the section cited above in five out of five children files were missing the Consent for Emergency Medical Treatment (LIC627) forms, which poses a potential health, safety or personal rights risk to persons in care.
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Type B
03/12/2025
Section Cited
CCR102425(j)(2)(D)(c)

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Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check.
This requirement is not met as evidenced by:
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Licensee had a blank copy of 15-minute sleep log. Licensee stated she will document every 15-minutes on the sleep log. Licensee will submit proof of 15-minute sleep log by 03/12/2025 to the Department.
Licensee had a blank 15 minute check form.
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Based on record review, the licensee did not comply with the section cited above and did not have 15-minute sleep log on file for two infants present, which 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.
SUPERVISOR'S NAME:Luisa Gavoutian
LICENSING EVALUATOR NAME:Lady Cabrera
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/26/2025 05:33 PM - It Cannot Be Edited


Created By: Lady Cabrera On 02/26/2025 at 03:08 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: MARTINEZ-LOMELI, ISABEL FAMILY CHILD CARE
FACILITY NUMBER: 543911187

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/12/2025
Section Cited
CCR
102418(g)(1)

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The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95)...
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Licensee is to complete the forms for all day care children enrolled not enrolled in school. Licensee is to submit copies to licensing office by 03/12/2025

Licensee had a blank CDPH 286. LPA briefly assisted with explaining the form.
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This requirement is not met as evidenced by:
Based on record review, the licensee did not comply with the section cited above. Three of the five children present did not have the CDPH form PM 286 on file. 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.
SUPERVISOR'S NAME:Luisa Gavoutian
LICENSING EVALUATOR NAME:Lady Cabrera
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/26/2025 05:33 PM - It Cannot Be Edited


Created By: Lady Cabrera On 02/26/2025 at 04:33 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: MARTINEZ-LOMELI, ISABEL FAMILY CHILD CARE
FACILITY NUMBER: 543911187

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/27/2025
Section Cited
CCR
102417(g)(5)

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The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground... through a pool cover...
This requirement is not met as evidenced by:
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Licensee stated she will purchase water pump hose to drain standing water and will purchase an approriate pool cover. Licensee will submit proof of drained water to the Department by 02/27/2025 before 5:00 p.m.

LPA provided AB2866 information and PIN25-01-CCP.
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Based on interview and observations, LPAs observed mesh tarp. LPAs observed more than 7 inches of accumulated rainwater, which is an immediate 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.
SUPERVISOR'S NAME:Luisa Gavoutian
LICENSING EVALUATOR NAME:Lady Cabrera
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2025


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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MARTINEZ-LOMELI, ISABEL FAMILY CHILD CARE
FACILITY NUMBER: 543911187
VISIT DATE: 02/26/2025
NARRATIVE
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LPA Navarrette will email Licensee the (TSP) Technical Support Program information offered through the Department of Social Services that provides support to licensees, AB 2866 information and PIN 25-01-CCP by 02/27/2025.

Exit interview conducted and report was reviewed with Licensee Isabel Martinez-Lomeli.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited LIC809D. Licensee was provided appeal rights.

LPA Cabrera informed Licensee Isabel Martinez-Lomeli that this report dated 02/26/2025 documents one Type A citation which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Cabrera informed the Licensee Isabel Martinez-Lomeli to provide a copy of this licensing report dated 02/26/2025 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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: Lady Cabrera
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2025
LIC809 (FAS) - (06/04)
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