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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911629
Report Date: 09/23/2021
Date Signed: 09/23/2021 11:16:15 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:DRAKE, JAMIE FAMILY CHILD CAREFACILITY NUMBER:
103911629
ADMINISTRATOR:DRAKE, JAMIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 977-5331
CITY:CLOVISSTATE: CAZIP CODE:
93619
CAPACITY:14CENSUS: 0DATE:
09/23/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jamie DrakeTIME COMPLETED:
11:30 AM
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Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On September 23, 2021, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Jamie Drake for a pre-licensing/change of location inspection. Applicant, her husband and three minor children reside in the home. Verified Applicant’s CPR and First Aid was completed through American Red Cross and expires on January 24, 2022. Applicant’s Assistant, Jessica Keller completed the training through American Red Cross and expires on August 17, 2023. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance or exemption. Fire clearance was granted on September 17, 2021.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • Fire clearance was received on September 21, 2021. Applicant states that fire inspector did not require for her to install a fire pull alarm.
  • This is a single story, three bedrooms, a game room that is located in the basement and two bathrooms home. Day care children will have access to the living room, dining room (office), den (day-care room), kitchen, bedroom #1, bedroom #2 and hallway bathroom. Off-limits rooms are made inaccessible by use plastic door knob covers.
  • There is no fireplace in the home.
(Continued on LIC809-C):
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma LomeliTELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: DRAKE, JAMIE FAMILY CHILD CARE
FACILITY NUMBER: 103911629
VISIT DATE: 09/23/2021
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  • LPA observed children size furniture, safe toys and books for the children. Children will nap in the day-care room, in the living room, bedroom #1 and bedroom #2 on mats. Infants will nap in play yards. LPA observed a parents board. Applicant understands she is to supervise children at all times.
  • Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
  • Preventative Health and Safety certification was completed. Applicant will need to update certification.
  • Knives are stored inside a top kitchen cabinet. Medications are stored inside a hallway cabinet that is made inaccessible by the use of a magnetic child proof lock. Cleaning compounds are stored in the cabinet located underneath the kitchen sink and made inaccessible by the use of a child proof safety latch.
  • Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
  • Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
  • There are no bodies of water in the home or premises.
  • There are two small dogs that are kept indoors/outdoors and will be accessible to the day-care children. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
  • Applicant states there are no firearms, ammunition or poisons in the home or premises.
  • Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
  • Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
  • Applicant states she will not be transporting day care children. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.
(Continued on LIC809-C):
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma LomeliTELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021
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: DRAKE, JAMIE FAMILY CHILD CARE
FACILITY NUMBER: 103911629
VISIT DATE: 09/23/2021
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  • Fenced backyard has bikes, scooters, slide play structure, Little Tikes peddle and go carts and other safe toys for the children. LPA observed a patio, porch swing, patio furniture and a fire pit that has a cover. There is a patio porch for shade.
  • SB 792 immunizations verified and on file.
  • Applicant complete the Mandated Reporter Training on February 18, 2020. Applicant’s assistant completed the training on September 17, 2020.
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
  • 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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. She is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday from 7:30 AM to 5:30 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.



Provisional License for a Small Family Day Care Home capacity of 14 children ages under 18 years will be issued for 90 days, pending receipt of the Preventive Health and Safety Training certification. Provisional license will be effective September 24, 2021.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma LomeliTELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021
LIC809 (FAS) - (06/04)
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