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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911349
Report Date: 03/21/2025
Date Signed: 09/24/2025 11:53:59 AM

Document Has Been Signed on 09/24/2025 11:53 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:HERNANDEZ, NANCY FAMILY CHILD CAREFACILITY NUMBER:
153911349
ADMINISTRATOR/
DIRECTOR:		HERNANDEZ, NANCYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 667-6495
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
03/21/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:15 AM
MET WITH:Nancy HernandezTIME VISIT/
INSPECTION COMPLETED:
11:15 AM
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On March 21, 2025, FAS was down. This is an electronic copy of the annual inspection conducted on March 21, 2025.

On March 21, 2025, Licensing Program Analyst (LPA), Elizabeth Martinez and Licensing Program Manager (LPM) Cynthia Brannon conducted an unannounced Annual Inspection and was met by licensee, Nancy Hernandez. Also present was the licensee’s adult son, who was assisting with providing care and supervision to the children in care and, the adult daughter. Days and hours of operation are Monday through Friday 4:30 AM to 4:30 PM. During today’s inspection, LPA observed 8 children, 3 children under the age of 2 years, and 5 children between 2 and four years.

LPA toured the home inside and outside and a census was taken. LPA reviewed the current facility sketch and confirmed that the children have access to the daycare room, bathroom in the daycare room, and the dining room area. Licensee has stairs. Upon completion of the renovation, the stairs will be made inaccessible to children in care. Currently, the licensee is utilizing a baby gate in the daycare room to ensure inaccessibility to the rest of the home during a renovation.

There is a built-in swimming pool in the backyard which is fenced and made inaccessible. The pool gate is self-latching, self-closing, and opens away from the swimming pool. No windows or doors have direct access to the pool area. Currently, the licensee has a pool alarm, mesh fencing, a lifebuoy, and a pool rescue hook. Due to the shape of the pool, the pool alarm worked when hitting the pool water next to the alarm. However, the pool alarm is situated in the small cove area near the steps; when splashing water at the other end of the pool, the alarm did not activate. It was suggested, that due to the shape of the licensee’s pool, which consists of a mountain pool shape with several coves, another alarm would be beneficial to ensure the alarm would be activated.

Continued on 809C***

NAME OF LICENSING PROGRAM MANAGER: Cynthia Brannon
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Martinez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2025
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 SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: HERNANDEZ, NANCY FAMILY CHILD CARE
FACILITY NUMBER: 153911349
VISIT DATE: 03/21/2025
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All firearms and ammunition are stored and locked separately. No poisons were observed during the inspection. Detergents, cleaning compounds, medication, and other hazardous items are made inaccessible.

There are no fireplaces or open-face heaters in the home. There is a working fire extinguisher that meets Title 22 regulations, a smoke detector, a carbon monoxide detector, and adequate heating and ventilation for safety and comfort.

This is a two-story home. Currently, due to the renovations, the children do not have access to the stairs due to licensee is utilizing a baby gate to prevent children from entering the areas that are being renovated. Safe play equipment is observed. The home has a working telephone service and LPA confirmed the phone number is (661) 667-6495.

The licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was completed on April 26, 2024. Licensee’s pediatric CPR/First Aid certification expires on September 14, 2026. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis, and measles.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

Licensee, Nancy Hernandez, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, before initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Continued on 809C***

NAME OF LICENSING PROGRAM MANAGER: Cynthia Brannon
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Martinez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2025
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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: HERNANDEZ, NANCY FAMILY CHILD CARE
FACILITY NUMBER: 153911349
VISIT DATE: 03/21/2025
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LPA discussed safe sleep regulations with the licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed the storage of medication and equipment/supplies and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/..

Licensee, Nancy Hernandez, was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

An exit interview was conducted and the report was reviewed with licensee, Nancy Hernandez. During the exit interview, the licensee, Nancy Hernandez, confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, of the California Code of Regulations, no deficiencies are cited. .Licensee, Nancy Hernandez, was provided appeal rights. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

FAS was down during 3/21/2025 inspection. LPA was unable to create the LIC 809 report for the licensee. LPA read the report in a Word document. LPA let the Licensee know we will send a copy of the document by mail.

NAME OF LICENSING PROGRAM MANAGER: Cynthia Brannon
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Martinez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4