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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503911422
Report Date: 12/20/2023
Date Signed: 12/27/2023 01:38:03 PM

Document Has Been Signed on 12/27/2023 01:38 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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:ZARAGOZA, LORENA FAMILY CHILD CAREFACILITY NUMBER:
503911422
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 4DATE:
12/20/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Lorena ZaragozaTIME COMPLETED:
10:00 AM
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On 12/20/2023 Licensing Program Analyst (LPA), Yesenia Fierro conducted an unannounced Annual Required Inspection and was met by Licensee, Lorena Zaragoza. LPA explained the reason for the visit. Also present was Staff #1 (S1) Luis Zaragoza. LPA Fierro confirmed days and hours of operation are Monday through Friday from 6:00 A.M to 6:00 P.M. The home has a working telephone service and LPA Fierro confirmed the phone number is (510) 388-7607. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

LPA Fierro conducted a census, capacity as specified on the license is being maintained. During todays visit there was four (4) children in care. A current facility sketch was reviewed, and Licensee confirmed the lower half of the home is used for care. Licensee confirmed the lower bottom bedroom, restroom, and playroom are used for providing care. All other rooms are off-limits and made inaccessible by use of plastic door spinners and gates. LPA Fierro toured the home inside and outside.

This is a two-story home; LPA observed the stairs located at the entrance of the home. Stairs are fenced children under age 5 years old are present. The fireplace located in the second floor of the home is made inaccessible by a glass door. Licensee stated that 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. LPA observed licensee test the smoke detector and carbon monoxide. Licensee understands to test both smoke detector and carbon monoxide periodically for functionality.

There are no pets, firearms, or ammunition on the premises. Licensee stated that all poisons are kept in a cabinet in the garage. LPA did not observe any poisons during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

CON'T 809-C

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ZARAGOZA, LORENA FAMILY CHILD CARE
FACILITY NUMBER: 503911422
VISIT DATE: 12/20/2023
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LPA Fierro overserved all indoor toys, play equipment, materials and surfaces accessible to children are clean and in operable condition. Floors and carpets are kept clean and in serviceable conditions. The outdoor play area in the backyard is fenced and there are no hazards to children present. LPA did not observe a swimming pool or other bodies of water on the premises. LPA Fierro observed all outdoor toys and play equipment are in serviceable condition.

Licensee has a current roster of the children. An emergency fire/disaster drill has been completed and documented on September 20, 2023. Licensee’s Mandated Reporter Training was completed on 10/12/2022. Licensee’s pediatric CPR/First Aid expires on 02/2025. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis, and measles.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

Licensee stated she is caring for infants. LPA observed one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. License stated that infants are not swaddled while in care. Licensee physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing 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.

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
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, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ZARAGOZA, LORENA FAMILY CHILD CARE
FACILITY NUMBER: 503911422
VISIT DATE: 12/20/2023
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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/. MyChildCarePlan.org – Centers and Family Child Care Homes Licensee [or facility representative] 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.

During the exit interview, the LICENSEE Lorena Zaragoza confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.



Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Lorena Zaragoza.

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC809 (FAS) - (06/04)
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