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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 545620530
Report Date: 08/30/2024
Date Signed: 08/30/2024 11:29:33 AM

Document Has Been Signed on 08/30/2024 11:29 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:FONSECA, SUSANA FAMLIY CHILD CAREFACILITY NUMBER:
545620530
ADMINISTRATOR/
DIRECTOR:		FONSECA, SUSANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 210-5737
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/30/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Susana FonsecaTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 08/30/2024, Licensing Program Analyst (LPA), Lady Cabrera and Licensing Program Manager, Luisa Gavoutian met with Applicant, Susana Fonseca for a pre-licensing inspection. Applicant's, Adult Son resides in the home. Verified Applicant’s CPR and First Aid was completed on 06/01/2024 with Emergency Medical Services Authority stickers (EMSA) and expires on 06/01/2026. Applicant’s Assistant, Elijah Stapleton completed the training on 08/10/2024 with Emergency Medical Services Authority stickers (EMSA) and expires on 08/10/2026. 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:
· Fire clearance was received on 07/10/2024. Fire pull alarm is located on the home’s dining area wall by the sliding exit door.
· This is a two story, four bedrooms and three 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 day care room, living room, kitchen and unfenced front yard. Applicant understands that when children are playing in the front yard, that licensees will provide full supervision.
· There is no fireplace. There is central air heating/cooling ventilation for safety and comfort.
· LPA observed child size furniture and safe toys for the day care children. Children will nap in the day care room on cots. Infants will nap in a play yard. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Infant Sleeping Plan and Safe Sleep handout.
· Facility has 2A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
· Preventative Health and Safety with Nutrition and Prevention of Lead exposure certification was completed on 06/28/2024.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2024
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 3
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: FONSECA, SUSANA FAMLIY CHILD CARE
FACILITY NUMBER: 545620530
VISIT DATE: 08/30/2024
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·Knives are stored in a container on top of the refrigerator. Medications are stored in the upstairs master bedroom. Cleaning compounds are stored in the garage, which is off limits to the children.
· 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 dogs that are kept in large kennel in the backyard. There is one bird in its cage in the patio area. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
· Applicant states there are no firearms or ammunition in the home or premises. Poisons are stored in a locked shed.
· 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.
· Fenced backyard is inaccessible currently. Applicant will notify the Department when the backyard is complete. Children will take walking field trips to a nearby park.
· Applicant completed the Mandated Reporter Training on 07/24/2024.
· LPA discussed safe sleep regulations.
· Applicant is advised it is her responsibility to read and maintain her facility incompliance with Title 22 Regulations. Title 22 Regulations can be found at www.ccld.ca.gov.
· SB 792 immunizations are on file.
· Applicant is advised Fresno Community Care Licensing Department has inspection authority and can inspect all rooms in the home, garages and/or separate dwellings on the premises.

· 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.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024
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: FONSECA, SUSANA FAMLIY CHILD CARE
FACILITY NUMBER: 545620530
VISIT DATE: 08/30/2024
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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 Saturday from 5:00 a.m. to 2:00 am, and as arranged.

LPA and 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.



Pending a final review of application file, licensure for a provisional license with a capacity of 8 children ages under 18 will be recommended effective 09/03/2024. Applicant is advised the following items must be corrected and documentation be sent to Fresno CCL within the next 30 days to avoid possible withdraw. Pending receipt of the below documentation, facility will be licensed for a Large Family Day Care Home capacity of 14 children ages under 18 years.

· Assistant’s required immunization records and tuberculosis.
SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2024
LIC809 (FAS) - (06/04)
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