545620165-4-19-2023-57-CC-NLOI-CR2SD3-20230419134629

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 545620165
Report Date: 04/19/2023
Date Signed: 04/19/2023 01:46:40 PM

Document Has Been Signed on 04/19/2023 01:46 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	VARGAS, VALERIA FAMILY CHILD CARE		FACILITY NUMBER:	545620165
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	04/19/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Valeria Vargas		TIME COMPLETED:	02:00 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 4/19/23, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Valeria Vargas for a pre-licensing/ change of location inspection. Applicant, her husband, and one minor child 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. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: This is a single story, two bedrooms and two bathrooms home and children will have access to the dining room (day care room), kitchen and hallway bathroom. Off-limits rooms are made inaccessible by use of child proof safety gates and plastic door knob covers. The family child care entrance is through the door that is located on the Southeast side of the home. There is an electrical fireplace in the living room that applicant states it will not be used during day-care hours. LPA observed in the day care room; children size furniture, safe toys, and books for the children. There is a large colorful alphanumeric area rug. Also, observed an infant swing. There is a parents board on the left hand side wall of the day care entry way. Children will nap in the day care room on mats. Infants will nap in play yards. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. Facility has 2A10BC fire extinguisher that is mounted to the day care room wall, smoke alarm, carbon monoxide alarm and first aid kit in place. (Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: VARGAS, VALERIA FAMILY CHILD CARE	FACILITY NUMBER: 545620165
	VISIT DATE: 04/19/2023

NARRATIVE

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Applicant’s Pediatric CPR and First Aid certification was completed through Pediatric Plus with Emergency Medical Services Authority stickers (EMSA) and expires on 2/19/24.
Preventative Health and Safety with Prevention of Lead exposure certification was completed on 2/4/22.
Knives and cleaning compounds are stored inside a top kitchen cabinet. Other cleaning compounds are stored inside the locked detached garage. Medications are stored in the inaccessible master bedroom. 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.
Applicant states there are no firearms or ammunition in the home or premises. Poisons are kept locked inside the detached garage.
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 a designated fenced area that is cemented and sodded for the children. LPA observed a toddler slide play set, a Lakeshore colorful play mat, child size table and chairs, books, color paint and other safe toys. There is a large patio porch for shade. LPA observed an attic entrance that is key locked and located in the play area. Applicant states that the attic entrance will be kept key locked at all times.
SB 792 immunizations verified and on file.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: VARGAS, VALERIA FAMILY CHILD CARE	FACILITY NUMBER: 545620165
	VISIT DATE: 04/19/2023

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Applicant completed the Mandated Reporter Training on 3/9/22.
LPA discussed safe sleep pending regulations and Safe Sleep Regulation 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 7:00 AM to 5:00 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 Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended effective 4/20/23.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

LIC809 (FAS) - (06/04)

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