165620030-9-9-2022-57-CC-NLOI-CJ4RNU-20220909131055

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 165620030
Report Date: 09/09/2022
Date Signed: 09/09/2022 01:11:08 PM

Document Has Been Signed on 09/09/2022 01:11 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:	LUCERO MENDEZ, JESSICA FAMILY CHILD CARE		FACILITY NUMBER:	165620030
ADMINISTRATOR:	LUCERO MENDEZ, JESSICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 904-1087
CITY:	HANFORD	STATE: CA	ZIP CODE:	93230
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/09/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Jessica Lucero Mendez		TIME COMPLETED:	01:15 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	Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On September 9, 2022, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Jessica Lucero Mendez for a pre-licensing/ change of location inspection. Applicant, her Father, her Mother, and three 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 August 22, 2022. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: Fire clearance was received on September 6, 2022. Fire pull alarm is located on the family room wall. This is a two story, four bedrooms and three bathrooms home and upstairs area will be off-limits to the day-care children. There is a bedroom downstairs that is made inaccessible to the day care children. Children will have access to the living room, family room (day care room), kitchen, dining room, and downstairs bathroom. There is a gate at the bottom of the stairs making upstairs area inaccessible. Off-limits rooms/closets are made inaccessible by the use of plastic door knob covers and key locks. There is a fireplace in the family room that applicant states it will not be used during day-care hours. (Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

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: LUCERO MENDEZ, JESSICA FAMILY CHILD CARE	FACILITY NUMBER: 165620030
	VISIT DATE: 09/09/2022

NARRATIVE

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LPA observed children size furniture, safe toys, and books for the children. Children will nap in the living room and in the family room on mats. There is a parents board in the day care room. LPA also observed a high chair. Infants will nap in cribs and 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 2A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
Applicant’s Pediatric CPR and First Aid certification was completed through American Red Cross and expires on February 16, 2024. Applicant’s Assistant, Lazaro Lucero completed through American Red Cross and expires on December 22, 2023.
Preventative Health and Safety certification was completed on November 5, 2019. Applicant will update the training which includes Prevention of Lead exposure
Knives and medications are stored inside top kitchen cabinets. Cleaning compounds are stored in the inaccessible garage.
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 is an in-ground that is fenced with a black rod iron fence in accordance with Title 22 Regulations. The gate is self-latching/self-closing, swings away from the pool and latching device is located no more than six inches from the top of the gate.
There is a dog that is kept in an upstairs bedroom. 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 kept key locked in a storage cabinet that is located in the garage.
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).

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

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: LUCERO MENDEZ, JESSICA FAMILY CHILD CARE	FACILITY NUMBER: 165620030
	VISIT DATE: 09/09/2022

NARRATIVE

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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.
Fenced backyard has a cemented and sodded area for the day care children. There are safe toys and patio furniture. LPA also observed a hammock and a batting cage.
SB 792 immunizations verified and on file.
Applicant completed the Mandated Reporter Training on February 21, 2022. Applicant’s assistant completed the training on February 20, 2022.
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 Sunday, 24 hours and as arranged. "Overnight Care" means care being provided to children anytime between the hours of 6 p.m. and 6 a.m. Care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered into care.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

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: LUCERO MENDEZ, JESSICA FAMILY CHILD CARE	FACILITY NUMBER: 165620030
	VISIT DATE: 09/09/2022

NARRATIVE

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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.

Applicant is advised the following items must be corrected and documentation be sent to Fresno CCL within the next 30 days to avoid possible withdraw.

Applicant will make the water pump that is located in the backyard's side run inaccessible to the day care children.
Facility is pending adult's fingerprints that are in process.

Pending verification of corrections of the above items, a final review of her application, Provisional licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended for 90 days, pending receipt of the Preventive Health and Safety Training certification.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

LIC809 (FAS) - (06/04)

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