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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103901764
Report Date: 03/23/2023
Date Signed: 03/23/2023 04:17:11 PM


Document Has Been Signed on 03/23/2023 04:17 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, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:MARTINEZ, PAMELA FAMILY CHILD CAREFACILITY NUMBER:
103901764
ADMINISTRATOR:MARTINEZ, PAMELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 276-0489
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY:14CENSUS: 5DATE:
03/23/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Pamela MartinezTIME COMPLETED:
04:30 PM
NARRATIVE
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On 03/23/2023, Licensing Program Analyst (LPA) Ka Vang conducted an unannounced Annual Required Inspection and was met by Licensee, Pamela Martinez. Present during today's inspection also Licensee's Assistant. Days and hours of operation are Tuesday through Friday, from 7:30 AM-5:30 PM.

The home has a working telephone service and LPA confirmed the phone number is (559) 276-0489 and (559) 977-8844.

LPA toured the home inside and outside. Census was taken and there five (5) day care children present. Current facility sketch (LIC 999A) was reviewed, and Licensee confirmed that the family room, daycare room, daycare bathroom, kitchen, and dining area are used for providing care and accessible to day care children. All other rooms are off-limits and made inaccessible to children by use of plastic doorknob cover. There is a fireplace located in the family room but made inaccessible to the children by the used of fire screen. There are no firearms in the home. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are inaccessible.

This is a single-story home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Fire drills are conducted and documented with the date, time and how many children present, every six months.

Safe toys and play equipment were observed and are in good condition, free of sharp, loose, or pointed parts. There are two dogs and a rabbit. Licensee understands the liability of pets around day care children and accepts responsibilities of any action taken by pets. The outdoor play area in the backyard is accessible to the children and is fenced and there are no hazards to children present.

During today’s inspection, LPA observed an in-ground pool. LPA observed Licensee open the pool gate half-way and around twelve inches, and it was observed that pool gate is self-latching, self-closing and opens away from the swimming pool. Swimming pool is fenced per regulation.

(Continued on LIC809-C).

SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4


Document Has Been Signed on 03/23/2023 04:17 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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


FACILITY NAME: MARTINEZ, PAMELA FAMILY CHILD CARE

FACILITY NUMBER: 103901764

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 03/23/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, licensee did not comply with the section cited above. During record reviewed, LPA observed Staff #1 (S1) and Staff #2 (S2) did not have the Mandated Reporter Training for the Child Care Providers (AB1207) in file which posed a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 04/07/2023
Plan of Correction
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Per licensee, she agreed that herself and her Assistant will take the Mandated Reporter Training for the Child Care Providers (AB1207) and submit the copies to Community Care Licensing (CCL)-Fresno by 04/07/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MARTINEZ, PAMELA FAMILY CHILD CARE
FACILITY NUMBER: 103901764
VISIT DATE: 03/23/2023
NARRATIVE
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Licensee has two (2) infant (Child #2 (C2) and Child #3 (C3) enrolled in the facility. There is one play yard for each infant in care, the play yard is kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the play yard. Infants are not swaddled while in care. Licensee provide proof of physically checking on C2 and C3 every fifteen minutes. LPA advised licensee that she is required to document any sign of distress, which includes but is not limited to flushed skin color, increase in body temperature, restlessness, and labored breathing on a sleeping log. Infants can be visually observed through an open door if sleeping in a separate room.

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 resources. 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.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. During record reviewed, there was no proof that Staff #1 (S1) and Staff #2 (S2) completed the Mandated Reporter Training for the Child Care Providers (AB1207). A citation of Type B was issued because it posed a potential health, safety, or personal rights risk to persons in care. Licensee’s pediatric CPR/First Aid expires on 02/2025. Assistant’s pediatric CPR/First Aid expires on 02/2025. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis, and measles.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

(Continued on LIC809-C).

SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MARTINEZ, PAMELA FAMILY CHILD CARE
FACILITY NUMBER: 103901764
VISIT DATE: 03/23/2023
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Incidental Medical Services (IMS) policy was discussed, and facility is not providing IMS. 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 ADA was provided: US Department of Justice (USDOJ) 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, available at: https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.



To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.


Per the California Code of Regulations, Title 22, Division 12, Chapter 3, the following deficiency is being cited during today’s inspection. (See next page, 809-D).

A notice of site visit was given and must remain posted for 30 days. Licensee was provided a copy of appeal rights.

Exit interview conducted and report was reviewed with licensee Pamela Martinez.
SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4