155621057-2-4-2026-57-CC-JRUZ-DQYRE3-20260204115653

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 155621057
Report Date: 02/04/2026
Date Signed: 02/04/2026 11:57:08 AM

Document Has Been Signed on 02/04/2026 11:57 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:	ORTIZ, ITZEL FAMILY CHILD CARE		FACILITY NUMBER:	155621057
ADMINISTRATOR/ DIRECTOR:	ORTIZ, ITZEL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 340-8033
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93308
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	02/04/2026
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:50 AM
MET WITH:	Itzel Ortiz		TIME VISIT/ INSPECTION COMPLETED:	12:15 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 02/04/2026, Licensing Program Analyst (LPA), Jose Ruiz met with Applicant, Itzel Ortiz for a change of location pre licensing inspection. Applicant, her husband and two minor children 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 1/21/2026. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: Fire clearance was received on 01/29/2026. Fire pull alarm is located on the home’s entry way on the left hand side wall. This is a single story, three bedroom and two-bathroom home and children will have access to the living room (day care room), bedroom #3, garage, kitchen and hallway bathroom. Off-limits rooms/ closets are made inaccessible by use of doorknob spinners and child safety gate. Applicant states the garage will only be used to load/unload the children when transporting children during rainy days. Parents board is mounted on the left side wall of the homes entry way. There is central air heating/cooling ventilation for safety and comfort. LPA observed in the living room, a changing table, three high chairs, four mats, a flat screen television mounted on the wall, child size furniture, safe toys, and books for the children. LPA observed in bedroom #3 three play yard for the children. LPA also observed in bedroom #3 twin bunk beds that applicant states will not be used for the children. Children will nap in living room on mats and infants will nap in bedroom #3 in play yard. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. (Continued on LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Jose Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

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: ORTIZ, ITZEL FAMILY CHILD CARE	FACILITY NUMBER: 155621057
	VISIT DATE: 02/04/2026

NARRATIVE

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Facility has a 2A10BC fire extinguisher mounted on the left side wall of the home entry way. There is a functioning smoke alarm, carbon monoxide alarm and first aid kit in place.
Applicant’s Pediatric CPR and First Aid certification was completed through EMS Safety with Emergency Medical Services Authority stickers (EMSA) and expires on 07/19/2027. Assistant Pediatric CPR and First Aid certification was completed through EMS Safety with Emergency Medical Services Authority stickers (EMSA) and expires on 7/19/2027.
Preventative Health and Safety with Nutrition and Prevention of Lead exposure certification was completed on 3/07/2024.
Applicant completed the Mandated Reporter Training on 12/02/2025. Licensee’s Assistant completed the training on 10/14/2025.
Knives are stored inside a top kitchen cabinet inaccessible to the children. Medications are stored inside the master bathroom inaccessible to the children. Cleaning compounds are stored inside the cabinet that is located underneath the kitchen sink, garage and underneath the cabinet in hallway bathrooms made inaccessible by the use of child safety latch and child safety gate.
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.
There is a small dog that is kept in the house. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
Applicant states there are no firearms or ammunition in the home or premises. Poisons are stored key locked in the storage shed in the back yard.
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 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.

(Continued on LIC809-C)

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Jose Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

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: ORTIZ, ITZEL FAMILY CHILD CARE	FACILITY NUMBER: 155621057
	VISIT DATE: 02/04/2026

NARRATIVE

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Fenced front yard has two toddler slides, a wood play house, three Little Tike ride on cars, two tricycles, and a canopy for shade, for the children. Fenced backyard will be off limits to the children.
LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
Applicant is advised it is her responsibility to read and maintain her facility incompliance with Title 22 Regulations. Title 22 Regulations can be found at www.ccld.ca.gov.
SB 792 immunizations are on file.
Applicant is advised Fresno Community Care Licensing Department has inspection authority and can inspect all rooms in the home, garages and/or separate dwellings on the premises.
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 6:00 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 02/05/2026.

NAME OF LICENSING PROGRAM MANAGER: Scott Herring
NAME OF LICENSING PROGRAM ANALYST: Jose Ruiz
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/04/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2026

LIC809 (FAS) - (06/04)

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