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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503906867
Report Date: 03/28/2024
Date Signed: 03/28/2024 12:19:24 PM

Document Has Been Signed on 03/28/2024 12:19 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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:DAVIS, ROSA FAMILY CHILD CAREFACILITY NUMBER:
503906867
ADMINISTRATOR:DAVIS, ROSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 605-6349
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
03/28/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Rosa Davis - LicenseeTIME COMPLETED:
01:00 PM
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On 03/28/2024, Licensing Program Analyst (LPA) Valerie Mireles conducted an unannounced Annual Required Inspection and was met by licensee Rosa "Rosie" Davis. Also present were licensee’s two assistants. A census was taken and there were nine children present. Capacity as specified on the license is being maintained. LPA toured the home inside and outside. Licensee is English and Spanish Speaking. Days of operation are Monday- Friday 7:00a.m. - 5:30p.m. The telephone number is (209) 605-6349.

LPA reviewed current facility sketch and confirmed that the daycare room and bathroom are used for providing care. All other rooms are off-limits and made inaccessible by locked doors and child safety gates. Licensee states that there are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There is one fireplace in the home located in the living room room and is made inaccessible by a glass door and child safety gate. Fireplace will not be in use during daycare hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Licensee conducted the most recent fire safety drill on 03/08/2024. This is a two-story and stairs are gated at the base of the stairs when children under age 5 years old are present. Safe toys and play equipment are observed. Licensee has child sized tables, chairs, a play shop, work stations and age appropriate toys, blocks and books.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. The outdoor play area in the backyard is fenced and there are no hazards to children present. There is no swimming pool or other bodies of water on the premises. The backyard has a covered sandbox, bicycles, building blocks, child size lounge area, tables and chairs. LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was completed on 11/21/2022. Licensee’s pediatric CPR/First Aid certification expires on 04/2025. A review of records indicates that all employees have immunization records on file for influenza, pertussis and measles.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2024
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: DAVIS, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 503906867
VISIT DATE: 03/28/2024
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LPA discussed the Community Care Licensing (CCL) website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed safe sleep regulations with licensee and discussed the CCL Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with licensee Rosa "Rosie" Davis. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited. Licensee was provided appeal rights. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2024
LIC809 (FAS) - (06/04)
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