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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911409
Report Date: 08/04/2022
Date Signed: 08/04/2022 10:21:53 AM

Document Has Been Signed on 08/04/2022 10:21 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:CEJA, KATRINA FAMILY CHILD CAREFACILITY NUMBER:
153911409
ADMINISTRATOR:CEJA, KATRINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 229-6699
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
08/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Katrina CejaTIME COMPLETED:
10:35 AM
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An unannounced Case Management inspection is conducted today by Licensing Program Analyst, (LPA) Gloria Reyes. LPA met with Licensee, Katrina Ceja. The purpose of today's visit is to conduct a 90 Day follow-up on initial prelicensing visit. Background clearances were reviewed and verified. This facility is licensed as a large facility of 14, there must be an additional qualified staff person present anytime the facility goes beyond the ratio for a capacity of eight. A tour of the home, inside and outside, as shown on the facility sketch was done. The areas of the home that day-care children will have access to is the primary day-care room which has a bathroom and kitchenette which is made inaccessible to children. Parents entered from the side gate. Required forms are posted. Children's files were reviewed today. The home has a current roster of the children, The home conducts fire and disaster drills at least once every six months and documents the date and time of each drill. Licensee documents immunizations and maintains and updates records for children in care. Fire extinguisher, smoke detector, carbon monoxide detector and first aid kit are operable and in place. Off-limits room is made inaccessible by child safety gate. Licensee stated there are no firearms or "bodies of water" in this home and nor did LPA observe these items.

Health and Safety training, Pediatric CPR, and Pediatric First Aid training are current and expires on 08/22. Licensee is scheduled to take her recertification. LPA verified that the required immunizations and the required Mandated Child Abuse Reporter (AB 1207) training was completed on 07/26/22.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. (see next page)

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Gloria Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2022
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: CEJA, KATRINA FAMILY CHILD CARE
FACILITY NUMBER: 153911409
VISIT DATE: 08/04/2022
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LPA reviewed Safe Sleep guidelines with licensee. Days/Hours of Operation: Monday through Friday, 5:00 AM to 4:00 PM.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiency cited.

Exit interview conducted with licensee. A copy of this report was provided and discussed. A Notice of Site Visit Form was posted to parent's board and must remain posted for 30 days.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Gloria Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2