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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911452
Report Date: 04/06/2023
Date Signed: 04/06/2023 02:32:30 PM

Document Has Been Signed on 04/06/2023 02:32 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CRUZ DE SEGOVIA, MARIA FAMILY CHILD CAREFACILITY NUMBER:
103911452
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
04/06/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Maria Cruz de SegoviaTIME COMPLETED:
02:45 PM
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On 04/06/2023, Licensing Program Analyst (LPA), Jeovanna Yanez conducted a capacity increase inspection from a Small Family Child Care Home to a Large Family Child Care Home. Present at time of inspection was Licensee, Maria Cruz de Segovia. Licensee, her husband, two adult children and three minor children reside in the home. Verified licensee CPR and First Aid was completed through HSI Pediatric with Emergency Medical Services Authority stickers (EMSA) and expires on January 19, 2025. Background criminal record clearances are verified and discussed, and LIS 531 is signed indicating that the adults living in the home and/or providing care and supervision to children have a criminal record clearance. Fire clearance was granted on March 13, 2023.

A tour of the home, inside and outside, as shown on the facility sketch, was conducted and the following was discussed and/or observed:
  • Fire clearance was received on March 14, 2023. Fire pull alarm is located on the home’s entry way on the right hand side wall.
  • LPA observed comfortable furnishings and a flat screen television mounted onto the wall.
  • Licensee states she does not have weapons, firearms, ammunition or poisons in the home.
  • Facility has 3A40BC fire extinguisher, carbon monoxide alarm, smoke alarm and first aid kit in place.
  • Licensee 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.
  • Licensee 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). Licensee states the home is smoke-free. (CONTINUED ON 809-C)
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2023
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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CRUZ DE SEGOVIA, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 103911452
VISIT DATE: 04/06/2023
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  • Licensee states she does transport day care children. Licensee understands that she must have proper restraints and/or car seats for all the children under her care when transporting children.
  • Required items are posted in the Child Care Home where parents may easily view.
  • During visit capacity worksheet was provided and discussed. Licensee understands an assistant must be present to meet capacity requirements of a Large Family Child Care home.
  • Licensee completed the Mandated Reporter Training on October 10, 2020.
  • LPA discussed safe sleep regulations and Safe Sleep Regulation Concepts were given licensee.

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

Licensee states her hours of operation are Monday through Friday from 6:00 AM to 6:00 PM and as arranged. Licensee advised she does not provide overnight care, less than 24 hours. Licensee is advised she may access forms and updated information on the CCLD website at www.ccld.ca.gov.

Licensee is advised the following items must be corrected and documentation be sent to Fresno CCL within the next 30 days to avoid possible withdraw.
· Licensee is to update the AB 1207 Mandated Reporter Child Care Provider specific training.

Pending verification of corrections of the above items and a final review of her application, licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended.

During exit interview, LPA observed licensee post the Notice of Site Visit on parent’s board and understands it must remain posted for 30 days and retain evaluation report for 3 years.
SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023
LIC809 (FAS) - (06/04)
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