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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 545620406
Report Date: 12/17/2024
Date Signed: 12/17/2024 10:07:30 AM

Document Has Been Signed on 12/17/2024 10:07 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CONTRERAS, KARISSA FAMILY CHILD CAREFACILITY NUMBER:
545620406
ADMINISTRATOR/
DIRECTOR:		CONTRERAS, KARISSAFACILITY TYPE:
850
ADDRESS:3732 N LEILA STTELEPHONE:
(559) 736-0782
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
12/17/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:12 AM
MET WITH:Karissa ContrerasTIME VISIT/
INSPECTION COMPLETED:
10:30 AM
NARRATIVE
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On 12/17/2024, case management visit is conducted by Licensing Program Analysts (LPAs) Lady Cabrera and Anita Tristan and met with Licensee Karissa Contreras.

On 10/30/2024, LPA arrived at the facility to investigate a complaint, it was confirmed the facility did not report the incident to Fresno Community Care Licensing (CCL) by telephone or fax within the CCL’s next working day and during its normal business hours. LPA provided Reporting Requirements regulation to Licensee. The incident occurred on 10/18/2024. Per records reviewed and interviews, CCL did not receive a phone call and/or an Unusual Incident Report. Facility did not comply with the reporting requirements regulation.

On 11/01/2024, Licensee reported the incident to CCL by telephone and an Unusual Incident Report was submitted to the CCL via email and fax.

During the complaint investigation, Licensee confirmed that uncleared Adult 1 provided care and supervision of children in care for “at least a week or two.” Licensee confirmed that uncleared Adult 2 attended the facility “more than twice” to observe day care routine and activities. Per Guardian Employee Roster and interview, Licensee did not comply with the criminal record clearance regulation. Civil penalties are being assessed today.

During investigation, Licensee admitted that Infant 1 was taken upstairs to Room 2 for nap time. Room 2 is deemed off-limits to children in care. Per Fire Safety Inspection dated 01/18/2024, it indicates the Family Child Care home is limited to first story and cannot use second story as it doesn’t comply with exiting requirements.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited on LIC809D. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. Appeal rights were provided to Licensee.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE: DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/17/2024
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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: CONTRERAS, KARISSA FAMILY CHILD CARE
FACILITY NUMBER: 545620406
VISIT DATE: 12/17/2024
NARRATIVE
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LPA Cabrera informed Licensee Karissa Contreras that this report dated 12/17/2024 documents one Type A citation which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Cabrera informed the Licensee Karissa Contreras to provide a copy of this licensing report dated 12/17/2024 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Lady Cabrera
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 12/17/2024 10:07 AM - It Cannot Be Edited


Created By: Lady Cabrera On 12/17/2024 at 09:14 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CONTRERAS, KARISSA FAMILY CHILD CARE
FACILITY NUMBER: 545620406

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/18/2024
Section Cited
CCR
102370(d)(1)

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102370(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing...(1) Obtain a California clearance or a criminal record exemption as required by the Department...This requirement is not met as evidenced by:
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 Licensee stated she would provide a written statement indicating her understanding of the regulations related to criminal record clearance.
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Based on interviews, the licensee did not comply with the section cited above. Licensee confirmed Adult 1 and Adult 2 have been present in the facility without a criminal record clearance, which poses an immediate health, safety or personal rights risk to persons in care.
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Written statement will be submitted by 12/18/2024. An Informal Office Meeting has been scheduled.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Luisa Gavoutian
LICENSING EVALUATOR NAME:Lady Cabrera
LICENSING EVALUATOR SIGNATURE:
DATE: 12/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/17/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/17/2024 10:07 AM - It Cannot Be Edited


Created By: Lady Cabrera On 12/17/2024 at 09:21 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CONTRERAS, KARISSA FAMILY CHILD CARE
FACILITY NUMBER: 545620406

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/02/2025
Section Cited
CCR
102416.3(a)(6)

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102416.3 Alterations to Existing Building or Grounds (a) Prior to making alterations or additions to a family child care home...the licensee shall notify the Department ... (6) Any change from an area of the family child care home previously identified as "off limits"...
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Licensee stated she would provide a written statement indicating her understanding of the regulations related to Alterations to Existing Building or Grounds regulation and will comply with current facility sketch. Written statement will be submitted by 01/02/2025.
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This requirement is not met as evidenced by:
Based on interview and record review, the licensee did not comply with the section cited above when she took infant in an inaccessible area upstairs in Room 2, which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Luisa Gavoutian
LICENSING EVALUATOR NAME:Lady Cabrera
LICENSING EVALUATOR SIGNATURE:
DATE: 12/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/17/2024


LIC809 (FAS) - (06/04)
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