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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103904070
Report Date: 12/05/2019
Date Signed: 12/05/2019 09:01:18 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:HERNANDEZ, ALMA FAMILY CHILD CAREFACILITY NUMBER:
103904070
ADMINISTRATOR:HERNANDEZ, ALMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 875-4114
CITY:SANGERSTATE: CAZIP CODE:
93657
CAPACITY:14CENSUS: 5DATE:
12/05/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Alma HernandezTIME COMPLETED:
09:00 AM
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Licensing Program Analyst (LPA), Rene Mancinas JR, conducted an unannounced annual inspection and met with Licensee, Alma Hernandez. LPA toured the home inspecting areas accessible to children and a census was taken. Licensee confirmed that the kitchen, dining room, living room, children’s playroom, and children’s bathroom, are used for providing care and are accessible to children. This is a single-story home. There are no swimming pools or other bodies of water on the premises. There are no firearms or ammunition present at this facility. Safe toys and play equipment are observed. Cleaning compounds, medication and other hazardous items are made inaccessible. No poisons were observed during inspection. There is a fireplace that is screened off and not in use during day care hours. There is working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Fire/disaster drills are conducted and documented at least once every six months as required per regulations. There is a pet at this home. Licensee understands the responsibility of any action taken by pet involving day care children. Capacity as specified on the license is being maintained. Licensee’s pediatric CPR/First Aid expires on 04/20/20 and AB 1207 Mandated Reporter Training expires 03/01/2020. A review of records indicates that immunization records are in file for children and licensee. Licensee had a current roster of children in care and maintains emergency information and forms as required. Licensee has a working telephone and the above telephone number was verified. Adequate supervision is being provided during this visit. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and notification of ‘Parents Rights’ poster are located near the front door entrance of the home. Licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address. Hours of operation are Monday-Friday, 07:00 am to 05:30 pm, or as arranged.

(Continued on 809-C)

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: HERNANDEZ, ALMA FAMILY CHILD CARE
FACILITY NUMBER: 103904070
VISIT DATE: 12/05/2019
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Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide these services. The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

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

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are being cited today. This report shall be made available to the public upon request. LIC 9213 Notice of Site Inspection is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2