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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103906112
Report Date: 10/04/2023
Date Signed: 10/04/2023 01:50:35 PM


Document Has Been Signed on 10/04/2023 01:50 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:THOMAS, JONNETTA FAMILY CHILD CAREFACILITY NUMBER:
103906112
ADMINISTRATOR:THOMAS, JONNETTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 473-6259
CITY:FRESNOSTATE: CAZIP CODE:
93722
CAPACITY:14CENSUS: 10DATE:
10/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:AssistantsTIME COMPLETED:
02:05 PM
NARRATIVE
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On 10/04/2023, Licensing Program Analyst (LPA) Ka Vang conducted an unannounced Annual Required Inspection and was met by Assistants (Staff #2 and Staff #3). Days and hours of operation are Monday through Friday, from 7:00 AM-6:00 PM. The home has a working telephone service and LPA confirmed the phone number is (559) 473-6259.

Staff #2 stated that the daycare home provides breakfast, lunch, and snack for the daycare children throughout the day. For infants who do not eat solid food, parents bring the infants formula or baby food to the daycare home and the staff will feed the infants based on parents’ instructions.

LPA toured the home inside and outside. Census was taken and there ten daycare children present. Current facility sketch (LIC 999A) was reviewed, and Staff #2 confirmed that the living room, dining room, kitchen, family room, daycare room (bedroom) and restroom in daycare room are used for providing childcare and accessible to the daycare children. All other rooms are off-limits and made inaccessible to the daycare children by the used of plastic doorknob cover. There is a portable fireplace located in the living room but made inaccessible to the children by the use of a fire screen. Staff #2 stated that 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 two-story home and stairs are gated when children under age 5 years old are present. 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 in the home. 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. There is no swimming pool or other bodies of water on the premises. (Continued on LIC809-C).

SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2023
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 10


Document Has Been Signed on 10/04/2023 01:50 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: THOMAS, JONNETTA FAMILY CHILD CARE
FACILITY NUMBER: 103906112

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(a)(10)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information: (10) A signed and dated copy of the Notice of Employee Rights [LIC 9052, (Rev. 03/03)] as required by Section 102416(a) and Section 102417.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. There were no proof Staff #2 and Staff #3 have personnel record of the Notice of Employee Rights (LIC 9052) in file which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 10/13/2023
Plan of Correction
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Per Staff #2 she agreed that she will inform licensee regarding Staff #2 and Staff #3 not having their Notice of Employee Rights (LIC 9052) in file. Staff #2 agreed that she will ensure that licensee submit proof of the Employee Rights (LIC 9052) to Community Care Licensing (CCL)-Fresno by 10/13/2023.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as Staff #1, Staff #2 and Staff #3 did not have proof of been immunized against the influenza or that they decline the influenza for 2022-2023 in file which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 10/13/2023
Plan of Correction
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Per Staff #2 she agreed that she will inform licensee regarding Staff #1, Staff #2 and Staff #3 not having proof of been immunized against the influenza or that they decline the influenza for 2022-2023 in file. S2 agreed that she will ensure that licensee submit proof to Community Care Licensing (CCL)-Fresno by 10/13/2023.
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: 10/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2023
LIC809 (FAS) - (06/04)
Page: 2 of 10


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: THOMAS, JONNETTA FAMILY CHILD CARE
FACILITY NUMBER: 103906112
VISIT DATE: 10/04/2023
NARRATIVE
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Staff #2 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 resource. LPA also informed licensee [or facility representative] 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.



There are three infants enrolled in the facility. Licensee understands that there shall be 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. Staff #2 provided proof of physically checking on infants every fifteen minutes 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. Licensee understands that infants can be visually observed through an open door if sleeping in a separate room.

Licensee and staff 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. Staff #2’s mandated reporter training completed on 03/25/2023. Staff #3’s mandated reporter training completed on 10/08/2022. Staff #2’s pediatric CPR/First Aid expires on 06/2025. A review of records indicates that Licensee, S2 and S3 have immunization records on file for TB clearance, pertussis, and measles. A review of records indicated that Licensee, Staff #2, and Staff #3 did not have immunization records on file for the influenza. A deficiency of Type B was issued during today’s inspection. (Continued on LIC809-C).
SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
LIC809 (FAS) - (06/04)
Page: 9 of 10
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: THOMAS, JONNETTA FAMILY CHILD CARE
FACILITY NUMBER: 103906112
VISIT DATE: 10/04/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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/resources/child-care-centers/.

LPA and Staff #2 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.



Staff #2 was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiencies are being cited during today’s inspection. (See next page, LIC809-D).

Staff #2 was provided a copy of appeal rights. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Staff #2. During the exit interview, Staff #2 confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
SUPERVISOR'S NAME: Rene MancinasTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Ka VangTELEPHONE: (559) 410-0327
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2023
LIC809 (FAS) - (06/04)
Page: 10 of 10