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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 155620289
Report Date: 01/04/2024
Date Signed: 01/04/2024 04:53:47 PM

Document Has Been Signed on 01/04/2024 04:53 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:CISNEROS, ANA FAMILY CHILD CAREFACILITY NUMBER:
155620289
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
01/04/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
04:10 PM
MET WITH:Ana CisnerosTIME COMPLETED:
05:05 PM
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A second announced pre-licensing inspection was conducted today by Licensing Program Analyst (LPA), Norma Lomeli. Met with Spanish-speaking Applicant, Ana Cisneros, her husband and her adult son 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.

The purpose of today's inspection is to inspect the following corrections were made.
  • LPA observed that the black wrought iron gate is self-latching/self-closing and swings away from the pool. The latching device is located no more than six inches from the top of the gate.
  • LPA observed that the three windows to the home do not have direct access to the in-ground pool. LPA observed that there is a five foot fence that barricades access to the body of water from side run of the home where the three windows are located.
  • LPA made the PG & E meter that is located on the left side run of the home by barricading it with a wooden fence.

Licensure as a Small Family Day Care Home capacity of 8 children will be recommended effective 1/8/24.

* Planned hours of operation are Monday through Friday from 5:00 AM to 5:00 PM.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 01/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/04/2024
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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