545620045-8-31-2022-57-CC-NLOI-CHU8SU-20220831224653

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 545620045
Report Date: 08/30/2022
Date Signed: 08/31/2022 10:47:32 PM

Document Has Been Signed on 08/31/2022 10:47 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:	GUERRERO, TIERNEY FAMILY CHILD CARE		FACILITY NUMBER:	545620045
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	08/30/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	04:30 PM
MET WITH:	Tierney Guerrero		TIME COMPLETED:	05:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On August 30, 2022, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Tierney Guerrero for a pre-licensing/ change of location inspection. Applicant, her husband, her adult son and her adult daughter reside in the home. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: This is a two story, four bedrooms and two and half bathrooms home and upstairs area will be off-limits to the day-care children. There is a gate at the bottom of the stairs making upstairs area inaccessible. Care and supervision will be provided in living room, dining room, kitchen, downstairs bedroom #1 (day care room) and downstairs bathroom. Off-limit rooms/closets are made inaccessible by the use of a plastic door knob covers and child proof safety gate. There is no fireplace in the home. LPA observed in the day care room; children size furniture, safe toys and books for the children. Children will nap in the living room and day care room on mats and sleeping bags. Infants will nap in play yards. Applicant understands she is to supervise children at all times. Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. Applicant’s Pediatric CPR and First Aid certification was completed through American Red Cross and expires on April 30, 2024. (Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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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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: GUERRERO, TIERNEY FAMILY CHILD CARE	FACILITY NUMBER: 545620045
	VISIT DATE: 08/30/2022

NARRATIVE

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Preventative Health and Safety with Prevention of Lead exposure certification was completed on May 7, 2023.
Knives and medications are stored inside a bottom kitchen cabinet made inaccessible by the use child proof safety latch. Cleaning compounds are stored inside the bottom kitchen cabinet that is made inaccessible by the use of a child proof safety latch. Other cleaning compounds are stored in the inaccessible laundry room.
Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time.
Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
There are no bodies of water in the home or premises.
There are two dogs and a tortoise that are kept in an fenced area inaccessible to the day care children. There are two cats that are kept in the inaccessible master bedroom. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
Firearms are stored in accordance with Title 22 Regulations and ammunition is stored separate in accordance with Title 22 Regulations.
Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
Applicant states she will not be transporting day care children. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.
Fenced backyard has a cemented and soiled area for the day care children. There is a patio porch for shade. LPA observed a child size picnic table, tricycles, a Little Tikes basketball hoop, Little Tikes toddler slide and peddle and go cart.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

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: GUERRERO, TIERNEY FAMILY CHILD CARE	FACILITY NUMBER: 545620045
	VISIT DATE: 08/30/2022

NARRATIVE

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SB 792 immunizations verified and on file.
Applicant completed the Mandated Reporter Training on December 20, 2021.
LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. 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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. Applicant is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday from 7:00 AM to 5:230 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

Licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended effective September 1, 2022.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 08/30/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2022

LIC809 (FAS) - (06/04)

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