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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103909654
Report Date: 05/20/2026
Date Signed: 05/20/2026 11:05:38 AM

Document Has Been Signed on 05/20/2026 11:05 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:ANDERSON, ALLISON FAMILY CHILD CAREFACILITY NUMBER:
103909654
ADMINISTRATOR/
DIRECTOR:		ANDERSON, ALLISONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 765-7708
CITY:CLOVISSTATE: CAZIP CODE:
93612
CAPACITY: 14TOTAL ENROLLED CHILDREN: 15CENSUS: 10DATE:
05/20/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Allison AndersonTIME VISIT/
INSPECTION COMPLETED:
09:15 AM
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On 5/20/2026 Licensing Program Analyst (LPA) Sha Fee Vang and Licensing Program Manager (LPM) Joseph Pacheco arrived at the facility to conduct an unannounced case management inspection. LPA and LPM met with Licensee, Allison Anderson and explained the reason for the inspection. On 3/17/2026 Licensee reported an unusual incident to the Fresno Childcare Regional Office. On that date at approximately, 9:55 am, Licensee and day care assistant were supervising day care children outside playing in the backyard. One of the children was playing on the play structure in the backyard and utilizing the rock-climbing wall when the child lost their footing and slipped. As a result, the day care child hit their mouth on one of the footings causing them to bite their tongue. During today’s inspection, Licensee stated that she was visually supervising the child from approximately 10 feet away while also maintaining visual supervision of the other children. Licensee contacted parent immediately and they arrived approximately 15 minutes later. While parent was on the way, Licensee comforted child and applied ice to the wound. Licensee stated that parent took child for medical attention. Child was prescribed medications that were administered by the parent while child was at home.

During today’s inspection, LPA and LPM observed the play structure to be free from loose or pointed parts. The play structure appeared to be safe in good repair. LPA and LPM observed a manufacturer’s warranty tag on the play structure which stated that the structure is intended for children ages 3-10. LPA and LPM discussed best practices with Licensee to only have the play structure used by children with the manufacturers suggested age range and always maintaining appropriate supervision of children.

(Continued on LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Joseph Pacheco
NAME OF LICENSING PROGRAM ANALYST: Sha Fee Vang
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/20/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ANDERSON, ALLISON FAMILY CHILD CARE
FACILITY NUMBER: 103909654
VISIT DATE: 05/20/2026
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This appears to be an isolated incident, and staff took appropriate measures to address the child’s injury, following appropriate policies, regulation, and reporting requirements.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies are cited during today’s inspection.

Exit interview was conducted with Licensee, Allison Anderson. Licensee was provided a copy of her Licensee rights. This report shall be made available to the public upon request. LIC9123 Notice of Site Visit was provided and required to be posted for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Joseph Pacheco
NAME OF LICENSING PROGRAM ANALYST: Sha Fee Vang
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2026
LIC809 (FAS) - (06/04)
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