103906269-5-29-2019-04-CC-SNAO-BCMQBA-20190529120112

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103906269
Report Date: 05/29/2019
Date Signed: 05/29/2019 12:01:24 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:	MONTIEL, NICOLE FAMILY CHILD CARE		FACILITY NUMBER:	103906269
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 7	DATE:	05/29/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Nicole Montiel		TIME COMPLETED:	12:15 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	On 5/29/2019 at 9:10 AM, Licensing Program Analysts (LPAs), Stephanie Navarro and Luisa Gavoutian, conducted an unannounced annual/random inspection. LPAs met with Licensee, Nicole Montiel. LPAs conducted a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. Licensee has a large dog that is kept indoors and is accessible to children. Licensee is aware of the safety of children around animals. There are no stairs in the home. There is an in-ground pool that is fenced with mesh fencing in accordance with Title 22 Regulations. The gate is self-latching/self-closing and swings away from the pool. There are no firearms in this home. There are no poisons on the premises. LPAs observed cleaning supplies located under the unlock kitchen sink cabinet. LPAs observed toiletry items such as deodorant and lotions located under the unlock bathroom sink cabinet. Fireplace is inaccessible to children as it is barricaded by glass door. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. There is a working telephone and number was verified. Capacity as specified on the license is being maintained. LPAs observed 1 infant and 6 preschool children present during inspection. Licensee failed to maintain ratio as one of the seven children present are required to be a school aged child. Licensee has a current roster of the children. Licensee maintains documentation of immunizations for the children. Licensee maintains documentation of immunizations for herself. Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Licensee documents and conducts fire drills 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 provided Adult Pediatric CPR/First Aid card and expires 5/23/2020. Licensee completed AB1207 Mandated Reporter Training and expires 6/7/2020. Continued on 809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7980
LICENSING EVALUATOR NAME: Stephanie Navarro	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019

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: MONTIEL, NICOLE FAMILY CHILD CARE	FACILITY NUMBER: 103906269
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/29/2019

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(4)

Physical Plant - Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a chil. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above. LPAs observed cleaning supplies located under the unlock kitchen sink cabinet. LPAs observed tolietry items such as deonarant and lotions located under the unlock bathroom sink cabinet. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/12/2019
	Plan of Correction
1 2 3 4	Licensee agreed to replace the safety locks for the bathroom and kitchen cabinets. Licensee agreed to submit pictures of new safety locks installed to Community Care Licensing Fresno Regional Office by 6/12/2019.

Type B

Section Cited

HSC

1597.44

Staffing Ratio and Capacity

A small family day care home may provide care for more than six and up to eight children, without an additional adult attendant, if all of the following conditions are met: (a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above. LPAs observed 1 infant and 6 preschool children present during inspection. Licensee failed to maintain ratio as one of the seven children present are required to be school aged. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/12/2019
	Plan of Correction
1 2 3 4	Licensee agreed to submit a letter stating how Licensee plans to remain within ratio to Community Care Licensing Fresno Regional Office by 6/12/2019.

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: Susie Fanning	TELEPHONE: (559) 650-7980
LICENSING EVALUATOR NAME: Stephanie Navarro	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019

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: MONTIEL, NICOLE FAMILY CHILD CARE	FACILITY NUMBER: 103906269
	VISIT DATE: 05/29/2019

NARRATIVE

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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.

Hours of operation are Monday – Friday; 06:30am -5:30pm.

Incidental Medical Services (IMS) policy was discussed. Licensee stated she is not providing IMS services at this time. 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

LPA Navarro & licensee discussed the Community Care Licensing website, Lead Safety and Mandated Reporter Training: LPA Navarro and licensee discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN. LPA Navarro left a copy of A Child Care Provider’s Guide to Safe Sleep.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations the following deficiencies are cited on LIC 809-D.

Licensee was handed a copy of appeal rights. Exit interview was conducted with Nicole Montiel.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

LIC 9213 NOTICE OF SITE INSPECTION FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7980
LICENSING EVALUATOR NAME: Stephanie Navarro	TELEPHONE: (559) 243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019

LIC809 (FAS) - (06/04)

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