061309496-7-9-2019-13-CC-LCHZ-BDWUTG-20190709155156

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 061309496
Report Date: 07/08/2019
Date Signed: 07/09/2019 03:52:03 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	MUNOZ, IRENE FAMILY CHILD CARE HOME		FACILITY NUMBER:	061309496
ADMINISTRATOR:	MUNOZ, IRENE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 458-2341
CITY:	COLUSA	STATE: CA	ZIP CODE:	95932
CAPACITY:	14	CENSUS: 8	DATE:	07/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Irene Munoz		TIME COMPLETED:	04:05 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	An annual random inspection was made to the facility by Licensing Program Analyst (LPA), Laura Chavez. A review of the Facility Personnel Report Summary dated 7/5/2019 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Two adults currently reside in the home. During today's inspection the home and grounds were toured. The licensee and her assistant were supervising eight children, and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The facility’s operating hours are 5:00am to 6:00pm, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the laundry room, master bedroom/bathroom, and the back bedroom and were made inaccessible by locks and doorknob covers. The home is clean, orderly and comfortable. There are safe toys and equipment available for children. The licensee stated there is a working telephone in the home. The licensee’s pediatric CPR and First Aid certifications were reviewed, and expire on 3/21/2021. Items which could pose a danger to children (such as detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. Poisons are locked in a storage room located on the side of the home. The fireplace in the living room is for ornamental purposes. The LPA observed a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The roster of children in care was reviewed and was current. The licensee has conducted an emergency drill within the past six months, last drill was documented on 6/4/2019. The licensee stated there are no firearms and/or other dangerous weapons in the home and none were observed during today's inspection. The children use the backyard as the outdoor play area and it is fully fenced. LPA observed an inflatable pool, approximately 8'x5'x2' in size filled half way with water. The pool is located in the gated, off-limits patio area in the back yard. The patio area and the children's play area are in physically separate fenced in areas. Three sides of fence that surround the pool meet pool fencing requirements. The fourth fenced area is 4' high. The gate does not swing out and is not self latching. During today's inspection LPA discussed with required pool fencing and gate requirements with the licensee. Eight children's records were reviewed at 2:55pm; current immunization's and Notification of Parent’s Rights forms were on file. The licensee is not providing Incidental Medical Services (IMS) to children in care. Report continued: See LIC809-C

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019

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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: MUNOZ, IRENE FAMILY CHILD CARE HOME	FACILITY NUMBER: 061309496
	VISIT DATE: 07/08/2019

NARRATIVE

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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 American Disabilities Act (ADA) was provided: US Department of Justice 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, www.ada.gov/childqanda.htm. This report, as well as information regarding Safe Sleep Practices, were reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

The following Type A violation of the California Code of Regulations, Title 22; Division 12, was observed: see LIC 809D. Appeal Rights were provided.

Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019

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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: MUNOZ, IRENE FAMILY CHILD CARE HOME	FACILITY NUMBER: 061309496
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/08/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/09/2019 Section Cited CCR 102417(g)(5)(A)	1 2 3 4 5 6 7	Operation of a Family Child Care Home: All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence.	1 2 3 4 5 6 7	During today's inspection the licensee emptied the inflatable pool of air and water. The licensee said she will be returning the pool to her daughter. The licensee stated she understands pool fencing requirements for all types of bodies of water.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: the licensee having an inflatable pool filled half way with water in the outdoor patio area. One side of the fence and the gate do not meet pool fencing requirements.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019

LIC809 (FAS) - (06/04)

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