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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620099
Report Date: 01/13/2023
Date Signed: 01/13/2023 12:39:24 PM

Document Has Been Signed on 01/13/2023 12:39 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:VIVEROS, LAURA FAMILY CHILD CAREFACILITY NUMBER:
155620099
ADMINISTRATOR:VIVEROS, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 664-9190
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
01/13/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Laura ViverosTIME COMPLETED:
12:45 PM
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On January 13, 2023, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Laura Viveros for a pre-licensing/ change of location inspection. Applicant and husband reside in the home. 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. Fire clearance was granted on 12/09/22.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • Fire clearance was received on 12/12/22. Fire pull alarm is located on the home’s hallway wall leading to the day care room.
  • This is a single story, four bedrooms, office and four bathrooms home and children will have access to the living room, family room, dining room/kitchen, bedroom #2 (nap room), bedroom #3 (nap room), Teen room (day care room) and hallway bathroom. Off-limits rooms are made inaccessible by use of lever locks.
  • There is a fireplace in the family room that applicant states it will not be used during day-care hours.
  • LPA observed in the day care room; children size furniture, safe toys, books, and a flat screen television mounted onto the wall. LPA observed seven high chairs and a child size table and chairs. Children will nap in bedroom #2, bedroom #3 and in the family room on mats. Infants will nap in play yards. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout.
  • Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 01/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/13/2023
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: VIVEROS, LAURA FAMILY CHILD CARE
FACILITY NUMBER: 155620099
VISIT DATE: 01/13/2023
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  • Applicant’s Pediatric CPR and First Aid certification was completed through Pediatric Plus with Emergency Medical Services Authority stickers (EMSA) and expires on 04/17/23. Applicant’s Assistant, Sandra Trejo who completed the training through Pediatric Plus with Emergency Medical Services Authority stickers (EMSA) and expires on 11/20/23.
  • Preventative Health and Safety with Prevention of Lead exposure certification was completed on 11/17/22.
  • Knives are stored in the kitchen on a top shelf. Medications are stored in a top cabinet. Cleaning compounds are stored inside the cabinet that is located underneath the kitchen sink and made inaccessible by the use of a child proof safety latch.
  • Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
  • 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.
  • Applicant states there are no pets in the home or on the premises.
  • Applicant states there are no firearms, ammunition or poisons in the home or premises.
  • 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.
  • Applicant states she will not be transporting day care children. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.
  • Fenced backyard has cemented and sodded area for the day care children. LPA observed two toddler slide play structures, toddler picnic bench, a basket ball hoop, tricycles, balls, child size table and chairs and other safe toys.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023
LIC809 (FAS) - (06/04)
Page: 2 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: VIVEROS, LAURA FAMILY CHILD CARE
FACILITY NUMBER: 155620099
VISIT DATE: 01/13/2023
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  • Applicant completed the Mandated Reporter Training on 09/24/22. Applicant’s Assistant completed the training on 12/18/22.
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
  • 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.

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 Friday from 7:00 AM to 5:30 PM and as arranged. No overnight care will be provided.

LPA & 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 as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended effective 01/17/22.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023
LIC809 (FAS) - (06/04)
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