103909606-7-27-2021-04-CC-LGAN-C5BSLA-20210727135800

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103909606
Report Date: 07/27/2021
Date Signed: 07/27/2021 01:58:12 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:	VELEZ-QUINTANILLA, MARDI FAMILY CHILD CARE		FACILITY NUMBER:	103909606
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	07/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Mardi Velez-Quintanilla		TIME COMPLETED:	02:10 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	On 07/27/2021, Licensing Program Analyst (LPA), Luisa Gavoutian, conducted an unannounced Annual Inspection. LPA was greeted by Licensee Mardi Velez-Quintanilla who accompanied LPA on a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. Present during today’s inspection were six children. The areas of the home that are accessible to the daycare children are the daycare room, kitchen, living room, one bedroom for napping, hallway bathroom, and fenced backyard. “Off-limits” rooms are made inaccessible by doorknob spinners. LPA observed a baby jumper in the living room. LPA discussed infant items that are and are not permitted in family child care homes. Licensee does not have any infants in care that are young enough to use the jumper. LPA observed an inflatable pool in the backyard, which was filled with approximately six inches of water. Licensee stated that the pool was used by the children at 11:30 a.m. as all the children were napping at time of inspection. LPA observed that the drain spout at the bottom of the pool was opened and Licensee stated that the water was draining slowly and that the pool was too heavy for Licensee to turn over to empty the water out. Licensee understands that inflatable pools must be emptied immediately after use. Licensee is being issues an immediate civil penalty of $500.00 for accessible bodies of water per Health and Safety Code Section 1597.58(c)(3), which states, “The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation, for any of the following serious violations: (3) Accessible bodies of water, when prohibited by this chapter or regulations adopted pursuant to this chapter.” During today’s inspection, LPA assisted Licensee in turning the inflatable pool over to empty it of the remaining water. One small dog was observed during today’s inspection; Licensee is aware of the safety of children around animals. Firearms and ammunition are locked and stored and locked separately according to regulation. No poisons were observed during the inspection. (Continued on LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

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: VELEZ-QUINTANILLA, MARDI FAMILY CHILD CARE	FACILITY NUMBER: 103909606
	VISIT DATE: 07/27/2021

NARRATIVE

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During today’s inspection, LPA observed kitchen knives, a screwdriver, hand sanitizer, and Clorox wipes accessible in the kitchen and a bottle of Lysol disinfectant spray on the bathroom sink. Licensee removed these items during today’s inspection. There is no fireplace. There is a working fire extinguisher, which was last serviced on 02/19/2021. The smoke detector and carbon monoxide indicator were both in working condition. The home has adequate heating and ventilation for safety and comfort. There are no stairs in the home. Safe toys and play equipment were observed.

There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. No infants under 12 months are enrolled. Licensee physically checks on sleeping infants every 15 minutes and document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room.

There is a working telephone and cellphone number was verified. Adequate supervision is being provided during this inspection. Licensee is aware that children shall not be left in parked vehicles. Children are supervised when outside in the play area and there are no hazards to children present. 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, which were all complete with emergency information as required. Licensee maintains documentation of immunizations for influenza, pertussis, and measles for herself. Licensee’s Pediatric CPR/First Aid are current expiring on 04/04/2022. Licensee’s Mandated Reporter training certificate was completed on 12/06/2019. 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 advanced notice. Days and hours of operation are Monday – Friday; 7:00 a.m. – 5:30 p.m. (Continued on LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

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: VELEZ-QUINTANILLA, MARDI FAMILY CHILD CARE	FACILITY NUMBER: 103909606
	VISIT DATE: 07/27/2021

NARRATIVE

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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.

This facility does not provide Incidental Medical Services – IMS. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disabilities Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA & Licensee discussed the Community Care Licensing (CCL) website (www.ccld.ca.gov) which provides access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Forms, and Regulations. Licensee stated she is receiving PINs and updates through email.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D). Licensee was provided a copy of appeal rights.

Upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 was given to licensee.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

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: VELEZ-QUINTANILLA, MARDI FAMILY CHILD CARE	FACILITY NUMBER: 103909606
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/27/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type A 07/28/2021 Section Cited	1 2 3 4 5 6 7	Operation of a Family Child Care Home; All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. This requirement was not met as
	8 9 10 11 12 13 14	evidenced by: Based on observation Licensee failed to make the inflatable pool, which had not been completely drained as described in LIC 809, inaccessible to daycare children. This poses an immediate risk to the health, safety, or personal rights of children.	8 9 10 11 12 13 14	A $500.00 immediate civil penalty is being assessed for accessible bodies of water.
	1 2 3 4 5 6 7
	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: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: VELEZ-QUINTANILLA, MARDI FAMILY CHILD CARE	FACILITY NUMBER: 103909606
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/27/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type B 08/10/2021 Section Cited	1 2 3 4 5 6 7	Operation of a Family Child Care Home; 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 was not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation, Licensee failed to make knives, cleaning detergents, and hand sanitizers inaccessible to children. This poses a potential risk to the health, safety, or personal rights of children.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	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: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

LIC809 (FAS) - (06/04)

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