503911993-2-22-2023-04-CC-JYAZ-CPARNC-20230222121006

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503911993
Report Date: 02/22/2023
Date Signed: 02/22/2023 12:10:14 PM

Document Has Been Signed on 02/22/2023 12:10 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:	BRYAN, TREAVIONA FAMILY CHILD CARE		FACILITY NUMBER:	503911993
ADMINISTRATOR:	BRYAN, TREAVIONA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 368-3054
CITY:	MODESTO	STATE: CA	ZIP CODE:	95355
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	02/22/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Treaviona Bryan		TIME 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 02/22/2023, Licensing Program Analyst (LPA), Jeovanna Yanez met with Applicant, Treaviona Byran for a pre-licensing inspection. Applicant, 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 or exemption. Fire clearance was granted on February 9, 2023. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: · Fire clearance was received on February 9, 2023. Fire pull alarm is located on the home’s living room wall on the far right hand side wall. · This is a single story three bedroom, one bathroom home and children will have access to the daycare room, backroom (infant room), and hallway bathroom. Off-limits rooms are made inaccessible by use of safety gates and/or door lever locks. Applicant will escort children to and from the backroom (infant room). · There is a fireplace in the living room that applicant states will not be used during day-care hours. · In the daycare room, LPA observed 5 ft. wooden furniture (cubbies) for storage, a TV mounted on a stand, a large oval rug with different colors, a large rectangle alphabet and color rug, learning wall art, children size furniture, safe toys, books and games for children. In the infant room, LPA observed a high chair, 3 wooden cribs, a changing table, and safe infant toys. Children will nap on mats in the daycare room, infants will nap in cribs in the infant room. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. · Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. (CONTINUED ON 809-C)

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

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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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: BRYAN, TREAVIONA FAMILY CHILD CARE	FACILITY NUMBER: 503911993
	VISIT DATE: 02/22/2023

NARRATIVE

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· Applicant’s Pediatric CPR and First Aid certification was completed through Heartsaver Pediartic with Emergency Medical Services Authority stickers (EMSA) and expires on September 10, 2024.
· Preventative Health and Safety with Prevention of Lead exposure certification was completed on August 24, 2020.
· Knives are stored on top of the refrigerator. Medications are stored in a top kitchen cabinet made inaccessible with a safety latch. Cleaning compounds are stored in a bottom kitchen cabinet made inaccessible with a safety latch.
· 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.
· Applicant states there are no pets in the home or on the premises.
· Firearms and ammunition are locked and stored separately in accordance with Title 22 Regulations.
· 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.
· Fenced backyard has cement and sodded area for the children. LPA observed a patio porch for shade. There is a little tykes slide, a large play yard, and safe toys for the day care children. There is a large, two-story wooden play structure, attached with a swing set. The ground level has a play kitchen, as well as a 4 foot wooden ladder and rock climbing attachment on one side of the structure that leads to the second level. The second level has a small observation deck with access to a green plastic slide, as well as a yellow sliding pole. This play structure is anchored to the ground.
· SB 792 immunizations verified and on file.
· Applicant completed the Mandated Reporter Training on October 20, 2022.
(CONTINUED ON 809-C)

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

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: BRYAN, TREAVIONA FAMILY CHILD CARE	FACILITY NUMBER: 503911993
	VISIT DATE: 02/22/2023

NARRATIVE

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· LPA discussed safe sleep regulations and Safe Sleep 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 Friday from 6:00 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 02/23/2023.

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

LIC809 (FAS) - (06/04)

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