103904987-1-23-2020-04-CC-DDMZ-BL538S-20200123170202

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103904987
Report Date: 01/21/2020
Date Signed: 01/23/2020 05:02:10 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:	PEREZ, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	103904987
ADMINISTRATOR:	PEREZ, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 646-9005
CITY:	PARLIER	STATE: CA	ZIP CODE:	93648
CAPACITY:	14	CENSUS: 6	DATE:	01/21/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Maria Perez		TIME COMPLETED:	05:10 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	Licensing Program Analyst (LPA) Diana Martinez conducted an unannounced annual/random inspection. LPA met with licensee Maria Perez. Also present was licensee’s assistant/husband Othoniel Perez. Six children were present today. LPA conducted an interior and exterior tour of the home. The accessible rooms are the kitchen, dining area, family room, children's playroom, bathroom, and living room/office that is used as a napping room for infants. The off-limits garage is made inaccessible with a key lock. Also observed were safe toys, play equipment, and materials. Licensee does not have any pets. Observed three tier fountain in the back yard containing plants in all tiers and no standing water. There are no 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. 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 landline 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's pediatric CPR/First Aid are current with the expiration date of 4/15/20; however, licensee's husband/assistant's CPR/First Aid expired in 5/2018. Husband/assistant transports children and on this day, he transported three school-age children. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that when any IMS is provided, a plan for providing IMS must be submitted to the licensing office. 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 System went into consistency check at 4:45 PM. LPA waited until 5:10 PM and advised licensee that a return visit will be required to obtain licensee's signature. Return visit was made on 1/23/20. (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: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

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: PEREZ, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 103904987
	VISIT DATE: 01/21/2020

NARRATIVE

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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; and Saturdays from 5:00 AM – 1:00 PM during the months of May – October.

LPA reviewed and provided information to licensee regarding safe sleep, lead exposure, parents’ board, children's files, and mandated reporter training website. LPA also discussed immunization requirements for all employees and volunteers, and the need to remove and/or make aloe vera plants and rose bushes in the backyard inaccessible to day care children. Licensee was also provided with a packet of licensing forms and a drill log.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiencies are found (see 809D):

Licensee was provided a copy of appeal rights.

An exit interview conducted with licensee Maria Perez 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.

**System went into consistency check at 4:45 PM. LPA waited until 5:10 PM and advised licensee that a return visit will be required to obtain licensee's signature. Return visit was made on 1/23/20.**

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: PEREZ, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 103904987
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/21/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/04/2020 Section Cited	1 2 3 4 5 6 7	Operation of a Family Child Care Home. The home shall be kept clean and orderly. This requirement was not met as evidenced by LPA’s observation of ants on kitchen counter. Licensee stated that it has been four days since ants appeared and has been using natural remedies. This poses a potential risk to the health, safety, or personal rights of children in care.
Type B 02/04/2020 Section Cited	1 2 3 4 5 6 7	Personnel Requirements. The Licensee and other personnel as specified shall complete training on preventive health practices including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement was not met as evidenced by husband/assistant's failure to renew his
	8 9 10 11 12 13 14	CPR/First Aid certification that expired in 5/2018. Assistant transports children and today he transported three school age children. This poses a potential risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14
	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: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020

LIC809 (FAS) - (06/04)

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