103904093-8-5-2019-04-CC-DDMZ-BES4Q7-20190805191751

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103904093
Report Date: 08/05/2019
Date Signed: 08/05/2019 07:18:00 PM

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:	CORTEZ, MARICELA FAMILY CHILD CARE		FACILITY NUMBER:	103904093
ADMINISTRATOR:	CORTEZ, MARICELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 646-1148
CITY:	PARLIER	STATE: CA	ZIP CODE:	93648
CAPACITY:	14	CENSUS: 5	DATE:	08/05/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Maricela Cortes		TIME COMPLETED:	11:45 AM

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"Spanish speaker" Licensing Program Analysts (LPAs) Diana Martinez and Angelica Mejia conducted an unannounced annual/random inspection. LPAs met with licensee Maricela Cortez. Also present were licensee’s husband/assistant Jose Cortez and minor daughter. Five children were present today. LPAs conducted an interior and exterior tour of the home. The accessible rooms are the living room, dining area, kitchen, children's playroom, bathroom and laundry room that is used as a diaper changing area and hand washing area. The off-limit rooms are made inaccessible with chain locks. Safe, healthful, and comfortable accommodations, furnishings, and equipment were observed. Also observed were safe toys, play equipment, and materials. Licensee does not have any pets. There are no bodies of water or firearms in this home. No poisons were observed on the premises. Cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace in living room is inaccessible to children. Fireplace is not used during day care hours nor at any other time. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. Stairs are barricaded when children under age 5 years old are present. There is a working cellular telephone and number was verified. Adequate supervision is being provided during this visit. Capacity as specified on the license is being maintained. A current roster of the children in care is maintained. Licensee maintains documentation of immunizations for the children. Licensee maintains documentation of immunizations against pertussis, measles and influenza for herself and assistants. Pediatric CPR/First Aid are current with the expiration date of 9/24/19.

LPAs discussed Incidental Medical Services (IMS) policy and provided handout Plan for Providing Incidental Medical Services (IMS) – FCCH Requirements. 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: http://www.ada.gov/childqanda.htm.

(See next page)

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2019

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: CORTEZ, MARICELA FAMILY CHILD CARE	FACILITY NUMBER: 103904093
	VISIT DATE: 08/05/2019

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Licensee has provided parents with a copy of the Identification and Emergency Information form (LIC 700). Fire drills are conducted and documented with the date and time every six months. Licensee is aware that children are never to be left in parked vehicles. 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. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice.
Days and hours of operation are Monday – Friday from 5:00 AM – 5:00 PM.

LPAs reviewed and provided information to licensee regarding safe sleep, parents’ board, and children's files. Licensee was provided with a packet of licensing forms and a lead poisoning facts brochure. LPAs also discussed with licensee that if no assistant provider is present at a large FCCH, then licensee must comply with the capacity requirements for a small FCCH. LPAs reviewed and provided licensee with the maximum capacity worksheet to prevent an over capacity deficiency.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies cited during today's visit.

An exit interview conducted with licensee Maricela Cortez and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2019

LIC809 (FAS) - (06/04)

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