103910599-9-25-2023-04-CC-MHEA-CVZTN9-20230925145222

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103910599
Report Date: 09/25/2023
Date Signed: 09/25/2023 02:52:37 PM

Document Has Been Signed on 09/25/2023 02:52 PM - 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:	MEDINA, CLAUDIA FAMILY CHILD CARE		FACILITY NUMBER:	103910599
ADMINISTRATOR:	MEDINA, CLAUDIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 853-8822
CITY:	FRESNO	STATE: CA	ZIP CODE:	93728
CAPACITY:	14	CENSUS: 5	DATE:	09/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Claudia Medina		TIME COMPLETED:	03:00 PM

NARRATIVE

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On September 25, 2023, Licensing Program Analyst (LPA), Miguel Herrera conducted an unannounced Annual Required Inspection and was met by Licensee Claudia Medina. Days and hours of operation are Monday through Friday, 6:00AM through 5:30PM. The home has working telephone service and LPA confirmed the phone number is 559-853-8822.

LPA toured the home inside and outside and a census was taken. LPA Herrera conducted a census and there is 5 children in the home during today’s visit. Capacity as specified on the license is being maintained. 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. LPA reviewed current facility sketch and confirmed that the living room, bathroom, kitchen, dining room, room #1 and backyard are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by locked doors. This is a two-story home; the second story of the home is inaccessible to children by a locked door. During the inspection licensee stated that the backyard is off limits to children at the moment since the “mother in law” room in the backyard is getting the roof repaired. Licensee states the repair began Friday after operating hours. Licensee stated the construction workers will begin working again after hours when children are not present and the project should be completed this evening. In the meantime, licensee made room #3 inaccessible by a locked door since her son is currently using the room while the roof is repaired. LPA Herrera did not observe any construction going on during the backyard inspection but did observe a pile of plywood.

The fireplace located in the living room is secured with a screen inaccessible to daycare children. There is no swimming pool in the premise, however there is a small in ground water fountain/pond in the front yard. LPA Herrera explained to licensee that the water feature is considered a “body of water”. Licensee Medina understands that the water feature can pose a safety risk to children in care. Licensee will make the water feature inoperable by turning off the fountain and licensee will fill the water feature with rocks to prevent water from accumulating when it rains.

To be continued on 809-C.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

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 09/25/2023 02:52 PM - 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: MEDINA, CLAUDIA FAMILY CHILD CARE	FACILITY NUMBER: 103910599
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102417(g)(5)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) 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 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 as LPA Herrera observed a water fountain/pond located in the front yard filled with water which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 09/26/2023
	Plan of Correction
1 2 3 4	Licensee Medina understands that the water feature can pose a safety risk to children in care. Licensee states she will make the water feature inoperable by turning off the water fountain and licensee will fill the water feature with rocks to prevent water from accumulating when it rains.Licensee will send photograph proof to Fresno RO by 09/26/2023.

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: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/25/2023 02:52 PM - 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: MEDINA, CLAUDIA FAMILY CHILD CARE	FACILITY NUMBER: 103910599
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that, LPA observed that Licensee did not update their Mandated Reporter Certificate which poses/posed a potential health, safety or personal rights risk to persons in care. Licensee last completed their Mandated Reporter on 6/17/2021.
	POC Due Date: 10/09/2023
	Plan of Correction
1 2 3 4	Licensee stated that she will complete the Mandated Reporter AB1207 and submit proof to CCL by POC due date. Training can be taken at www.mandatedreporterca.com available in English and Spanish.

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: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

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: MEDINA, CLAUDIA FAMILY CHILD CARE	FACILITY NUMBER: 103910599
	VISIT DATE: 09/25/2023

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Per licensee 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 a working fire extinguisher located in the laundry room. The smoke detector and carbon monoxide detector are in working conditions and are located in the 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. LPA was unable to observe the most current fire drill documentation with the date, time and how many children present. Licensee states she conducted the last fire drill in August but must have misplaced it. Licensee has a current roster of the children.

During the inspection, LPA observed safe toys and play equipment in the room designated for childcare. LPA did not observe any hazardous items in the kitchen. The bathrooms used by children were observed to be free from hazards.

Per Licensee, she has one dog in the home. Licensee understands the liability of pets around day care children and accepts responsibilities of any action taken by pets. The outdoor play area in the backyard is fenced.

LPA reviewed a sample of children’s files and observed files were complete with the immunizations and required documentation. Licensee’s Mandated Reporter Training expired on 06/17/2023. Licensee’s pediatric CPR/First Aid certification expires on 12/21/2023. A review of records indicates that licensee has immunization records on file for influenza, pertussis, and measles.

Licensee did not have infants enrolled in the facility. Licensee understands that if licensee enroll infants in the facility, there shall be one play yard for each infant in care, the play yard is 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. LPA advised licensee that she is required to observed sleeping infants every 15 minutes and document any sign of distress, which includes but is not limited to flushed skin color, increase in body temperature, restlessness, and labored breathing on a fifteen-minute sleeping log. Infants can be visually observed through an open door if sleeping in a separate room.

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).

To be continued on 809-C.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/0202

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: MEDINA, CLAUDIA FAMILY CHILD CARE	FACILITY NUMBER: 103910599
	VISIT DATE: 09/25/2023

NARRATIVE

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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.

LPA discussed safe sleep regulations with Licensee 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.

This facility does not provide Incidental Medical Services – IMS. Incidental 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.

To be continued on 809-C.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Miguel Herrera	TELEPHONE: (559) 341-0721
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

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: MEDINA, CLAUDIA FAMILY CHILD CARE	FACILITY NUMBER: 103910599
	VISIT DATE: 09/25/2023

NARRATIVE

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Exit interview conducted and report was reviewed with Licensee Claudia Medina. 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 during today’s visit (see 809-D).

Licensee Claudia Medina was provided 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 Acknowledgement of Receipt of Licensing Reports was given to Claudia Medina.

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: 09/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2023

LIC809 (FAS) - (06/04)

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