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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911517
Report Date: 05/12/2022
Date Signed: 05/12/2022 11:53:49 AM


Document Has Been Signed on 05/12/2022 11:53 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:WHITBEY, LINDA FAMILY CHILD CAREFACILITY NUMBER:
103911517
ADMINISTRATOR:WHITBEY, LINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 240-1847
CITY:CLOVISSTATE: CAZIP CODE:
93611
CAPACITY:14CENSUS: 9DATE:
05/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Linda Whitbey TIME COMPLETED:
12:05 PM
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On 05/12/22 Licensing Program Analyst (LPA), Araceli Gibson conducted an unannounced One Year Required Inspection and was met by Licensee, Linda Whitbey and hours of operation are Monday through Friday hours are 7:00 AM to 5:30 PM.

LPA toured the home inside and outside. Licensee had 9 children in care. Licensee confirmed that the living room, dining room, family room, and bathroom, kitchen, and back yard are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of safety gates and spinner knobs. 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. There are no firearms or ammunition on the premises. Detergents, poisons, cleaning compounds, medication and other hazardous items were inaccessible to daycare children.

There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are stairs in the home and maintained inaccessible by use of a safety gate. There is a fireplace with a glass enclosure made inaccessible in the living room. Fireplace is not in use during day care hours. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559) 240-1847.

There are no infants enrolled. LPA discussed Safe Sleep Regulations with licensee. There should be 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. Provider physically checks on sleeping infants every fifteen 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. Infants up to 12 months of age are placed on their backs for sleeping. Licensee understands the use of the Infant Sleep LIC 9227 form.

SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:
DATE: 05/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2022
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: WHITBEY, LINDA FAMILY CHILD CARE
FACILITY NUMBER: 103911517
VISIT DATE: 05/12/2022
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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced. LPA observed and discussed best practice to do a clean up to assure outdoor areas are clean and safe for children to use. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with the immunizations. Licensee completed the Mandated Reporter Training on 02/03/20 it has since expired (see 809D). Licensees’ pediatric CPR/First Aid expires on 02/12/24. Currently Licensee had one employee present and was able to provide evidence of immunization records on file for influenza, pertussis and measles.

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.

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 they provide any of these services. Information regarding Americans with Disability 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.



LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of 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 MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 05/12/2022 11:53 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: WHITBEY, LINDA FAMILY CHILD CARE

FACILITY NUMBER: 103911517

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 05/12/2022

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
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Based on record review, the licensee did not comply with the section cited above. Licensee was not able to provide evidence of a current Mandated Reporter Training for Child Care Providers (AB1207) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/19/2022
Plan of Correction
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LIcensee agrees to take the required Mandated Reporter Training for Child Care Providers (AB1207) and submit a copy of the certificate as evidence of course taken by Plan of Correction (POC) date 05/19/22.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Araceli GibsonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:
DATE: 05/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4