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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503912016
Report Date: 12/07/2023
Date Signed: 12/27/2023 09:31:57 AM

Document Has Been Signed on 12/27/2023 09:31 AM - 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:ANDRADE, ROSA FAMILY CHILD CAREFACILITY NUMBER:
503912016
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
12/07/2023
TYPE OF VISIT:Post LicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rosa AndradeTIME COMPLETED:
11:00 AM
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On December 7, 2023, Licensing Program Analyst (LPA), Yesenia Fierro conducted an unannounced case management inspection, LPA met with licensee Rosa. The purpose of today's inspection is to conduct a post licensing follow-up on the initial pre-licensing visit that took place on 05/04/2023. This is a single story, four (4) bedroom and two (2) bathroom home and children have access to the living room, dining room, kitchen, and backyard play area. Off-limits rooms are made inaccessible by the use of plastic doorknobs. There is a working telephone, and the number was verified to be (209) 446-2906. Days and hours of operation are Monday through Friday from 6:30 AM- 5:30 PM. No overnight care will be provided.

LPA observed safe toys and a clean and orderly home. There is a fireplace located in the dining room, and the fireplace has a glass door and screen preventing children from having access. The license stated fireplace will not be used during daycare hours. There are no bodies of water in the home, firearms, or ammunition in the home.

There is one small sized dog in the home. Licensee understands the liability of pets around day care children and accepts responsibilities of any action taken by pets.

No poisons were observed on the premises. Cleaning compounds, medications and other hazardous items are inaccessible to children. Operable fire extinguisher, smoke alarm, carbon monoxide and first aid kit are in place. Licensee’s CPR and first aid training are current with an expiration date February 11, 2025. LPA discussed with licensee, fire drills are required to be conducted and documented at least every 6 months. Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. Background clearances were discussed, and licensee understands that the adults living in the home and/or providing care and supervision to children shall be background cleared. LPA provided licensee with form LIC 9227 and safe sleep logs and reviewed with licensee how to fill out LIC 9227 and safe sleep logs.

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE: DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/07/2023
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: ANDRADE, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 503912016
VISIT DATE: 12/07/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm.

LPA & licensee discussed the Community Care Licensing Website, Lead Safety, and Mandated Reporter Training: LPA and licensee 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. LPA left a copy of A Child Care Provider’s Guide to Safe Sleep.

Per Title 22, Division 12, of the California Code of Regulations, no deficiencies were cited.

This report shall be made available to the public upon request.

LIC 9213 notice of site inspection form is required to be posted for 30 days.

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

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC809 (FAS) - (06/04)
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