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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503912458
Report Date: 03/02/2026
Date Signed: 03/02/2026 02:56:02 PM

Document Has Been Signed on 03/02/2026 02:56 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:MEDINA, DELIA FAMILY CHILD CAREFACILITY NUMBER:
503912458
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
03/02/2026
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Licensee Delia MedinaTIME VISIT/
INSPECTION COMPLETED:
03:00 PM
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On 03/02/2026, Licensing Program Analysts (LPAs) Jeovanna Yanez and Aurelio Mendoza conducted a joint capacity increase inspection from a Small Family Child Care Home to a Large Family Child Care Home. Present at the time of inspection was Licensee Delia Medina. Licensee, her adult daughter, her adult sons, and one minor child reside in the home. Background criminal record clearances were verified and discussed, and the Guardian Roster was 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 02/12/2026.

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 02/12/2026. Fire pull alarm is located in the home’s entryway on the left-hand side wall.
• On this date, 03/02/2026, 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 (EMSA) stickers and expires on 07/28/2026.
• Licensee completed the Mandated Reporter Training for Child Care Providers on 08/01/2024.
• Licensee provided proof of control of property.

NAME OF LICENSING PROGRAM MANAGER: Joseph Pacheco
NAME OF LICENSING PROGRAM ANALYST: Aurelio Mendoza
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: MEDINA, DELIA FAMILY CHILD CARE
FACILITY NUMBER: 503912458
VISIT DATE: 03/02/2026
NARRATIVE
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• LPAs observed child-size furniture, safe toys, and books for the children. LPAs also observed one high chair, a diaper-changing table, and one play yard. There is a parent’s board located on the left-hand side of the entryway. Required items are posted in the Child Care Home where parents may easily view.
• Facility has a 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 three dogs that are kept in the side run of the home. Licensee is advised it is her responsibility to ensure the safety of children in care at all times around the pets.
• Licensee states she does not have weapons, firearms, ammunition, or poisons in the home.
• 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 Division has inspection authority and can inspect all rooms in the home, garages, and/or separate dwellings on the premises.
• Licensee states she does transport day care children at this time however she may in the future. Licensee understands that she must have proper restraints and/or car seats for all the children under her care when transporting children.
• During the visit, capacity worksheet was provided and discussed. Licensee understands a qualified assistant must be present to meet capacity requirements of a Large Family Child Care Home.

LPAs 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. LPAs 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 that she register all infant devices with the CPSC to be notified of any recalls on purchased equipment. LPAs provided Licensee with the 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: U.S. Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and a link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

NAME OF LICENSING PROGRAM MANAGER: Joseph Pacheco
NAME OF LICENSING PROGRAM ANALYST: Aurelio Mendoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
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: MEDINA, DELIA FAMILY CHILD CARE
FACILITY NUMBER: 503912458
VISIT DATE: 03/02/2026
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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.

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 licensing-related information, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPAs 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 Licensee. Licensee was advised that she may access the 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 6:00 a.m. to 6:00 p.m. 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 with a capacity of 14 children will be recommended effective 03/03/2026.

NAME OF LICENSING PROGRAM MANAGER: Joseph Pacheco
NAME OF LICENSING PROGRAM ANALYST: Aurelio Mendoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
LIC809 (FAS) - (06/04)
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