103910636-5-3-2019-04-CC-JMOA-BBTNLM-20190503103347

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103910636
Report Date: 05/03/2019
Date Signed: 05/03/2019 10:33:57 AM

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:	MORRIS, DORTHINA FAMILY CHILD CARE		FACILITY NUMBER:	103910636
ADMINISTRATOR:	MORRIS, DORTHINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 779-4000
CITY:	FRESNO	STATE: CA	ZIP CODE:	93720
CAPACITY:	14	CENSUS: 11	DATE:	05/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Dorthina Morris		TIME COMPLETED:	10:45 AM

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 Analysts (LPAs) Juvenal Moctezuma and Joseph Pacheco conducted an unannounced Annual/Random inspection and met with Assistant, Keshia Graves. LPA explained the reason of the inspection and asked if Licensee was present. Keshia stated that the licensee was out running errands. LPA observed Keshia caring for 11 children without the licensee or another assistant. Keshia called licensee and licensee arrived approximately 10 minutes later. LPA explained the reason of the inspection to Dorthina Morris and a tour of the home was conducted both inside and outside. Licensee stated that children have access to the living room, dining room, play room, kitchen area, one bathroom, and backyard. All the bedrooms are remained closed and locked during day-care hours. LPA observed age appropriate toys in the play room and observed that the home was clean and free of toxins. The bathroom was found clean and free of toxins. The backyard has a fence that goes all around. There is plenty of shade and grass area. Licensee has placed plastic locks on some of her kitchen cabinets and drawers. The knives are stored on top of her refrigerator. The cleaning supplies/toxins are stored in licensees room which is remained closed and locked during day-care hours. LPA spoke about the safe sleep regulations that will take affect this year (2019) with the Licensee and reminded her to not store anything inside the cribs and playpens. Licensee has a 2A 10 BC fire extinguisher that was purchased on 10/31/2018. LPA reminded licensee that it needs to be serviced or replaced yearly. Licensees CPR/First Aid certificate is good until 10/07/2019. The last time Licensee conducted the fire/emergency drills with children was on April 18, 2019. LPA reminded licensee that she needs to conduct and document the fire/disaster drills at least every 6 months. The smoke detector and Carbon Monoxide was tested and found in working condition. 7 children's files were reviewed along with the children's roster and everything was completed and up to date. Report continued onto LIC 809-C

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

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: MORRIS, DORTHINA FAMILY CHILD CARE	FACILITY NUMBER: 103910636
	VISIT DATE: 05/03/2019

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Licensee stated that there are no guns or ammunition in the home and LPA did not observe any bodies of water during the inspection. Licensee and assistant are current with their immunization requirements per SB 792. Licensee and assistant have also taken the Mandated Reporter Training AB 1207.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

The following Type A deficiency was cited during todays inspection. Appeal rights were explained and provided to Licensee, Dorthina Morris.

Upon receipt of this report, licensee shall post for 30 days and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D. APPEAL RIGHTS GIVEN AND EXPLAINED.

Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

LPA observed licensee post the Notice of Site visit.
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

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: MORRIS, DORTHINA FAMILY CHILD CARE	FACILITY NUMBER: 103910636
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/06/2019 Section Cited CCR 102416.5	1 2 3 4 5 6 7	The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. This requirement was not met as evidenced by LPAs observing that Assistant, Keisha was caring for 11 children by herself.	1 2 3 4 5 6 7	Licensee stated she was out running and did not know that Assistant #1 was caring for more than 8 children. Licensee stated that children usually arrive later in the day. Licensee will write a POC stating how this will not
	8 9 10 11 12 13 14	The licensee was not present in the home. Keisha called licensee and licensee arrived approximately 10 minutes later. This poses an immediate Health/Safety Risk to children in care.	8 9 10 11 12 13 14	happen again and submit a copy to CCL by no later than 05/06/2019.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

LIC809 (FAS) - (06/04)

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