103910927-6-15-2021-04-CC-LGAN-C3ZTY9-20210615150823

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103910927
Report Date: 06/15/2021
Date Signed: 06/15/2021 03:08:31 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:	ROSALES, HILDA FAMILY CHILD CARE		FACILITY NUMBER:	103910927
ADMINISTRATOR:	ROSALES, HILDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 326-8801
CITY:	FRESNO	STATE: CA	ZIP CODE:	93727
CAPACITY:	14	CENSUS: 4	DATE:	06/15/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Hilda Rosales		TIME COMPLETED:	03:20 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 06/15/2021, Licensing Program Analysts (LPAs), Luisa Gavoutian and Stefanie Galvan, conducted an unannounced Annual Inspection. LPAs were greeted by Licensee Hilda Rosales who accompanied LPAs on a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. Also present was a fingerprint-cleared live-in adult relative. Present during today’s inspection were four children. The areas of the home that are accessible to the daycare children are the living room, dining room, kitchen, playroom, one bedroom, and hallway bathroom. During today’s inspection, Licensee requested to have one bedroom, that was previously licensed for use made “off-limits” to daycare children. “Off-limits” rooms are made inaccessible by locks or doorknob spinner. During today’s inspection, LPAs observed the outdoor play are was under construction. Licensee stated that a portion of the yard was having cement installed and children are not going outside. Licensee stated that construction began last weekend and is expected to be completed this weekend. The outdoor play area is being made “off-limits” to daycare children effective immediately. Licensee shall notify Community Care Licensing (CCL) when the project is complete; the backyard shall be inspected for safety prior to children having access. One small dog and two large dogs were observed during today’s inspection; Licensee is aware of the safety of children around animals. Licensee stated there are no firearms in this home. 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. No poisons were observed during the inspection. Fireplace is inaccessible to children by glass door and will not be in use during daycare hours. There is a working fire extinguisher, which was last serviced in October 2020. LPAs tested the smoke detector and carbon monoxide indicator, which 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. (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: 06/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2021

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: ROSALES, HILDA FAMILY CHILD CARE	FACILITY NUMBER: 103910927
	VISIT DATE: 06/15/2021

NARRATIVE

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No infants under 12 months of age are enrolled. 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. Licensee physically checks on sleeping infants every 15 minutes and documents 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. Car seats are used for transportation purposes only and are not used for sleeping children. Capacity as specified on the license is being maintained.

LPAs 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 and staff. Licensee’s Pediatric CPR/First Aid are current expiring on 09/12/2022. 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. – 6:00 p.m.

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.
(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: 06/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2021

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: ROSALES, HILDA FAMILY CHILD CARE	FACILITY NUMBER: 103910927
	VISIT DATE: 06/15/2021

NARRATIVE

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LPAs & Licensee discussed the 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. LPA thoroughly discussed safe sleep practices. LPAs discussed infant items permitted in Family Child Care Homes and left a visual handout. LPAs provided Licensee with the “Effects of Lead Exposure” brochure in accordance with AB 2370, Chapter 676, Statutes of 2018.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

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: 06/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2021

LIC809 (FAS) - (06/04)

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