103909654-1-27-2020-04-CC-CROZ-BL8U35-20200127141259

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103909654
Report Date: 01/27/2020
Date Signed: 01/27/2020 02:13:13 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:	WILSON, ALLISON FAMILY CHILD CARE		FACILITY NUMBER:	103909654
ADMINISTRATOR:	WILSON, ALLISON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 765-7708
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93612
CAPACITY:	14	CENSUS: 8	DATE:	01/27/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Allison Wilson		TIME COMPLETED:	02:30 PM

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On 01/27/2020, Licensing Program Analyst (LPA) Candis Rodriguez conducted an unannounced annual inspection. LPAs were greeted by Licensee Allison Wilson who accompanied LPAs on a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. Present during today’s inspection were eight (8) children and one (1) assistant. Rooms accessible to children are the living room, bedroom #1, bathroom, kitchen, and dining room. Days and hours of operation are Monday – Friday; 7:00AM to 5:30PM.

Two small dogs were observed in the home. There is a hot tub that is locked according to regulations. There is a working fire extinguisher, smoke detectors, and carbon monoxide detector. The home has adequate heating and ventilation for safety and comfort. There are stairs in the home which are kept inaccessible to children by safety gate.

There is a working telephone and number was verified. Adequate supervision is being provided during this visit. Children are supervised when outside in the backyard 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 maintains documentation of immunizations for herself and staff. Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A).

The last fire drill was conducted in October of 2019.

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 children are never to be left in parked vehicles.

(Continued on LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Candis Rodriguez	TELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2020

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: WILSON, ALLISON FAMILY CHILD CARE	FACILITY NUMBER: 103909654
	VISIT DATE: 01/27/2020

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Upon inspection of the facility, LPA observed multiple medications on the kitchen counter, accessible to children in care. Licensee immediately placed medications in an inaccessible area to children.

Pediatric CPR/First Aid are current expiring in February of 2021. 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.

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 she provides these services. The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINS), Quarterly Updates, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found: (see LIC809-D). Site Visit Notice posted on the parent board. Exit interview was conducted with Licensee.

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: Candis Rodriguez	TELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2020

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: WILSON, ALLISON FAMILY CHILD CARE	FACILITY NUMBER: 103909654
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/27/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/31/2020 Section Cited	1 2 3 4 5 6 7	102417(g)(4) 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 LPA's observations and interview with Licensee, Licensee did not ensure medications were kept inaccessible to children in care. This poses a potential risk to the health, safety, and personal rights of children in care.	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: Candis Rodriguez	TELEPHONE: (559) 341-4117
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2020

LIC809 (FAS) - (06/04)

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