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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 165620032
Report Date: 01/20/2023
Date Signed: 01/20/2023 03:50:45 PM

Document Has Been Signed on 01/20/2023 03:50 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:JIMENEZ, BLANCA FAMILY CHILD CAREFACILITY NUMBER:
165620032
ADMINISTRATOR:JIMENEZ, BLANCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 904-7451
CITY:LEMOORESTATE: CAZIP CODE:
93245
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Blanca JimenezTIME COMPLETED:
04:00 PM
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On 01/20/2023, Licensing Program Analyst (LPA) Daniel Alvarez conducted an unannounced Post Licensing inspection. The purpose of today’s inspection was to follow up with licensee, Blanca Jimenez since being initially licensed on 08/30/2022. Licensee did not have any day care children in care today as she was closed.

LPA reviewed required forms needed to be posted and forms needed for each child in care. LPA reviewed Safe Sleep practices and information available on the Department website (www.ccld.ca.gov), such as how to access Provider Information Notices (PINs) and other resources available to childcare providers. LPA Alvarez reviewed all forms and documents that should be posted, placed in children’s files and in licensee and assistant files. LPA reviewed the requirement to conduct fire drills and how often to document the fire drills. LPA reviewed the requirement to ensure all potentially dangerous items are inaccessible to children and that she should ensure her carbon monoxide detector, smoke detector and fire extinguisher are functioning at all times. LPA reviewed Unusual Incidents and how to report such incidents to the Department. LPA encouraged licensee to contact the Department should she have any pending questions about regulation requirements.

Hours of operation are Monday through Sunday, 24 hours a day.

Per California Code of Regulations Title 22 Division 12 Chapter 3, no deficiency is being cited today. Notice of Site Visit to be posted for 30 days.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Daniel Q Alvarez
LICENSING EVALUATOR SIGNATURE: DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/20/2023
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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