103908542-9-24-2019-04-CC-CHAS-BGBR4R-20190924124158

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103908542
Report Date: 09/24/2019
Date Signed: 09/24/2019 12:42:02 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:	WELTCHEK, ELIZABETH FAMILY CHILD CARE		FACILITY NUMBER:	103908542
ADMINISTRATOR:	WELTCHEK, ELIZABETH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 970-6073
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93619
CAPACITY:	14	CENSUS: 11	DATE:	09/24/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Elizabeth Weltchek		TIME COMPLETED:	01:00 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) Caroline Harris conducted an unannounced annual/random inspection. LPA met with Licensee Elizabeth Weltchek. Also present was her assistant. LPA conducted a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. Licensee has 3 dogs that are kept in an off limits room when children are present. Licensee is aware of the safety of children around animals. Licensee takes responsibility for any action taken by pets. There are no "bodies of water" or firearms in this home. The LPA observed the licensee to have numerous toys inside and outside and an educational room set up for the day care children. There were no poisons observed on the premises accessible to children. Cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is inaccessible to children. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. There are no stairs in the home. There is a working telephone and the number was verified. Adequate supervision is being provided during this visit. Licensee is aware that children are to be supervised at all times when outside in the unfenced play area. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee maintains documentation of immunizations for the children. Licensee also maintains documentation of immunizations against pertussis, measles and influenza for herself and staff. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 any of these services.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

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: WELTCHEK, ELIZABETH FAMILY CHILD CARE	FACILITY NUMBER: 103908542
	VISIT DATE: 09/24/2019

NARRATIVE

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Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). 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. Pediatric CPR/First Aid are current and expire on 11/24/21. 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; 7:00 AM – 5:30 PM.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

Exit interview was conducted with Licensee. LPA reviewed with licensee the Mandated Child Abuse Reporter Training, which her and her staff have completed. LPA also provided the licensee with information on Safe Sleep requirements and reviewed the regulation changes. Information on Lead Poisoning was also provided to the licensee and she was informed that copies need to be provided to all current parents and any future parents of children enrolled along with posting the information on the parent board.
LPA informed licensee about the Community Care Licensing website: www.ccld.ca.gov. and discussed with licensee about the new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Updates that inform licensees of new legislation and regulations. Licensee was advised that forms and updated information may be obtained on the CCLD website and was also advised that it is her responsibility to stay current with regulations.

A copy of this report was provided and discussed. THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline Harris	TELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

LIC809 (FAS) - (06/04)

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