103910560-8-29-2023-04-CC-MHEA-CV6LEF-20230829084129

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103910560
Report Date: 08/28/2023
Date Signed: 08/29/2023 08:42:26 AM

Document Has Been Signed on 08/29/2023 08:42 AM - 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	NAST, NICOLE FAMILY CHILD CARE		FACILITY NUMBER:	103910560
ADMINISTRATOR:	NAST, NICOLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 440-9082
CITY:	CLOVIS	STATE: CA	ZIP CODE:	93611
CAPACITY:	14	CENSUS: 7	DATE:	08/28/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:05 AM
MET WITH:	Nicole Nast		TIME COMPLETED:	01:20 PM

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On August 28, 2023 Licensing Program Analyst (LPA), Migue Herrera conducted an unannounced Annual Required Inspection and was met by Licensee Nicole Nast. During the inspection LPA Herrera observed an Assistant present. Days and hours of operation are Monday through Friday, 7:00 AM through 4:45 PM. The home has working telephone service and LPA confirmed the phone number is 805-440-9082.

LPA toured the home inside and outside and a census was taken. LPA Herrera conducted a census and there are 7 children in the home with Licensee. Capacity as specified on the license is being maintained. LPA reviewed current facility sketch and confirmed that the Daycare room, living room, bathroom, bedroom 1, dining room and kitchen are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by safety knobs.

There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There is one fireplace in the home located in the living room and is made inaccessible by a screen and will not be in use during daycare hours. There is a working fire extinguisher located behind the kitchen door leading to the garage. The smoke detector and carbon monoxide detector are in working conditions and are in the home’s hallway. Licensee understands to test both smoke detector and carbon monoxide periodically for functionality. There is adequate heating and ventilation for safety and comfort of the children. Fire drills are conducted and documented with the date, time and how many children present, at least every six months. Licensee has a current roster of the children.

This is a single level home and there are no stairs. During the inspection, LPA observed safe toys and play equipment in the daycare room. Hazardous items in the kitchen are made inaccessible by way of child safety locks on the cabinets. The bathroom used by daycare children was observed to be free from hazards. LPA observed 1 small dog indoors in the home. Licensee understand the liability of pets around day care children and accepts responsibilities of any action taken by pets.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

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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Document Has Been Signed on 08/29/2023 08:42 AM - 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: NAST, NICOLE FAMILY CHILD CARE	FACILITY NUMBER: 103910560
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/28/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(1)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above. Licensee states she misplaced the safe sleep logs that document safe sleep for all infants in care. Licensee states she does document sleep checks for infants in care but was unable to provide records to LPA at the time of the inspection.
	POC Due Date: 09/11/2023
	Plan of Correction
1 2 3 4	Licensee will check on sleeping infants and document on safe sleep log. Licensee will submit two weeks of safe sleep log to Fresno Community Care Licensing Office by 09/11/2021.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: NAST, NICOLE FAMILY CHILD CARE	FACILITY NUMBER: 103910560
	VISIT DATE: 08/28/2023

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The outdoor play area in the backyard is fenced, and the swimming pool is fenced per regulation. The pool gate is self-latching, self-closing and opens away from the swimming pool. No windows or doors have direct access to the pool area. LPA advised licensee to supervise children at all times due to the west side neighbor having a pool. LPA advised for licensee to conduct frequent safety inspections of the play structure to check for any loose parts, cracks, and hazards. Licensee is aware of child safety around the play structure and assumes all responsibility. Licensee ensures that children in care are supervised at all times and is aware of the neighboring pool.

LPA reviewed all children’s files in attendance, and observed files were complete with immunizations and complete emergency information as required. Licensee’s Mandated Reporter Training expired on 07/19/2023. Licensee’s pediatric CPR/First Aid expires on 08/2024. Licensee has all required immunizations on file. Currently Licensee has one Assistant, and all immunizations are on file. Assistant’s Mandate Reporter Training expires on 09/2023, CPR/First Aid expires on 08/01/2025. 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.

There are 2 infants enrolled during today’s inspection. LPA discussed Safe Sleep Regulations with licensee. There is one play yard for child #6 located in the living room. Per Licensee Child #1 can physically climb out of the play yard therefore he sleeps in a sleeping pad with the rest of the children in the daycare room. Play yard and sleeping pad are 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. Per licensee she physically checks on sleeping infants every fifteen minutes documenting sleep for any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness, and labored breathing. Per Licensee infants that are up to 12 months of age are placed on their backs for sleeping. During today’s inspection LPA observed missing/incomplete 15-minute sleeping logs for the 2 infants present.

LPA discussed safe sleep regulations with licensee Nicole Nast and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee 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.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: NAST, NICOLE FAMILY CHILD CARE	FACILITY NUMBER: 103910560
	VISIT DATE: 08/28/2023

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LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

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.

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/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare 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.

Exit interview conducted and report was reviewed with licensee Nicole Nast. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (Continued LIC. 809-D).

Licensee Nicole Nast was provided appeal rights. 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: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

LIC809 (FAS) - (06/04)

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