545620166-5-10-2023-57-CC-NLOI-CRQ2KT-20230510172829

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 545620166
Report Date: 05/10/2023
Date Signed: 05/10/2023 05:28:40 PM

Document Has Been Signed on 05/10/2023 05:28 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:	VARGAS, ALYCIA & GONZALES, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	545620166
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/10/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	03:45 PM
MET WITH:	Alycia Vargas and Maria Gonzales		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	On 5/10/23, Licensing Program Analyst (LPA), Norma Lomeli met with Applicants, Alycia Vargas and Maria Gonzales for a pre-licensing/ change of locations inspection. Applicants, applicant’s husband and her three minor children 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 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 the living room, dining room, kitchen, den (day care room), downstairs bedroom and downstairs bathroom. Off-limit rooms/closets are made inaccessible by the use of plastic door knob covers. There is a fireplace in the living room that applicant states it will not be used during day-care hours. There is heating/cooling ventilation for safety and comfort. LPA observed in the day care room; child size furniture, safe toys and children's books and a flat screen television and a parents board mounted onto the wall. There is a high chair in the dining room. Children will nap in day care room and dining room on nap mats. Infants will nap in downstairs bedroom on play yards. Applicants understand they are to supervise children at all times. Facility has 2A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. (Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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: VARGAS, ALYCIA & GONZALES, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 545620166
	VISIT DATE: 05/10/2023

NARRATIVE

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Applicants completed Pediatric CPR and First Aid certification through American Red Cross expires on 2/21/25.
Preventative Health and Safety with Prevention of Lead exposure certification was completed on 3/7/23.
Knives are stored inside the kitchen pantry that is made inaccessible by the use of a plastic door knob covers. Medications and cleaning compounds are stored in the laundry room that is made inaccessible.
Advised applicants fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
Applicants are 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.
Applicants state there are no pets in the home or on the premises.
Firearms are stored in accordance with Title 22 Regulations and ammunition is stored separate in accordance with Title 22 Regulations. Poisons are kept locked inside a shed that is located in the backyard.
Applicants are 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).
Applicants are 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). Applicants state the home is smoke-free.
Applicants state they will not transport day care children. Applicants understands they must have proper car restraints and/or car seats for all the children under her care when transporting children.
Fenced backyard has patio furniture, tricycles, water table, Step 2 playhouse, two Step 2 toddler slides and toddler benches for the children.
SB 792 immunizations verified and on file.
Applicant, Alycia Gonzales completed the Mandated Reporter Training on 10/14/22. Applicant, Maria Gonzales completed the Mandated Reporter Training on 12/8/21.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

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: VARGAS, ALYCIA & GONZALES, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 545620166
	VISIT DATE: 05/10/2023

NARRATIVE

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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. Applicants are advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. Applicant are also reminded that it is their responsibility to read the regulations periodically. Applicants state they will operate her day care Monday through Friday from 6:00 AM to 4:00 PM and as arranged. No overnight care will be provided.

LPA & applicants discussed the Community Care Licensing website: LPA and applicants 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.

Pending a final review of application file, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended effective 5/11/23.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023

LIC809 (FAS) - (06/04)

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