503912299-10-22-2024-04-CC-JYAZ-DAASHB-20241022135317

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503912299
Report Date: 10/22/2024
Date Signed: 10/22/2024 01:53:27 PM

Document Has Been Signed on 10/22/2024 01:53 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:	CORREA, BERENICE FAMILY CHILD CARE		FACILITY NUMBER:	503912299
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 12	CENSUS: 2	DATE:	10/22/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:05 PM
MET WITH:	Berenice Correa		TIME VISIT/ INSPECTION COMPLETED:	01:55 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 10/22/2024, Licensing Program Analyst (LPA), Jeovanna Yanez conducted a capacity increase inspection from a Small Family Child Care Home to a Large Family Child Care Home. Present at time of inspection was Licensee. Licensee, her husband and and four minor children reside in the home. Background criminal record clearances are verified and discussed, and LIS 531/Roster Report were signed indicating that the adults living in the home and/or providing care and supervision to children have a criminal record clearance or exemption. Fire clearance was granted on October 1, 2024. A tour of the home, inside and outside, as shown on the facility sketch, was conducted and the following was discussed and/or observed: · Fire clearance was received on October 4, 2024. Fire pull alarm is located on the home’s entry way on the left hand side wall. · On this date, 10/22/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ. · Licensee’s CPR and First Aid was completed through HSI Pediatric with Emergency Medical Services Authority stickers (EMSA) and expires on September 14, 2025 · Licensee completed the Mandated Reporter Training on August 2, 2023. (CONTINUED ON 809-C)

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

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: CORREA, BERENICE FAMILY CHILD CARE	FACILITY NUMBER: 503912299
	VISIT DATE: 10/22/2024

NARRATIVE

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· Licensee rents/leases the home, proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. Licensee obtained a signed Property Owner/Landlord Consent form (LIC 9149)..
· LPA observed children size furniture, safe toys and books for the children. LPA also observed an infant swing and one play yard. There is a parent’s board that is located on the right hand side wall of the home’s entry way and on the living room wall. Required items are posted in the Child Care Home where parents may easily view.
· LPA inspected the off-limits bedroom #3 during the inspection, due to licensee revising her facility yard sketch and making the bedroom accessible to children in care. There is children size table, chairs and furniture, wooden cubbies for storage, and a 55 gallon fish tank that is secure. LPA observed bedroom #3 to be free of hazards. Bedroom #3 is now approved for daycare use.
· Facility has 2A10BC fire extinguisher, carbon monoxide alarm, smoke alarm and first aid kit in place.
· There are no bodies of water in the home or premises.
· There are two (2) dogs and five (5) chickens kept in off-limits areas, and 12 fish in a 55 gallon fish tank located in bedroom #3. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
· Firearms and ammunition are locked and stored separately in accordance with Title 22 Regulations.
· Licensee 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.
· Licensee 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). Licensee states the home is smoke-free.
· Licensee is advised Fresno Community Care Licensing Department has inspection authority and can inspect all rooms in the home, garages and/or separate dwellings on the premises.
· Licensee states she does not be transport day care children. Licensee understands that she must have proper restraints and/or car seats for all the children under her care when transporting children.
(CONTINUED ON 809-C)

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

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: CORREA, BERENICE FAMILY CHILD CARE	FACILITY NUMBER: 503912299
	VISIT DATE: 10/22/2024

NARRATIVE

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· During visit capacity worksheet was provided and discussed. Licensee understands an assistant must be present to meet capacity requirements of a Large Family Child Care home.

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 and-resources/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. LPA provided applicant with Individual Infant Sleeping Plan and Safe Sleep handout.

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) or (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

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.
(CONTINUED ON 809-C)

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

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: CORREA, BERENICE FAMILY CHILD CARE	FACILITY NUMBER: 503912299
	VISIT DATE: 10/22/2024

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities,
providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly
Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

LPA reviewed with licensee the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. Applicant was advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. Licensee is also reminded that it is her responsibility to read the regulations periodically. Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. Licensee states she will operate her day care Monday through Friday from 7:00 am to 10:00 pm and as arranged. No overnight care will be provided.

The home meets the description of a safe and healthy environment for children as described in Chapter 3, Division 12, Title 22 of the California Code of Regulations and is adequate for a Large Family Day Care Home (LFDCH). Licensure as a Large Family Day Care Home capacity of 14 children will be recommended effective 10/23/2024.

Exit interview conducted and report was reviewed with licensee. A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

LIC809 (FAS) - (06/04)

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