153805475-5-16-2023-57-CC-JPEE-CRVQX2-20230516123249

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153805475
Report Date: 05/16/2023
Date Signed: 05/16/2023 12:32:59 PM

Document Has Been Signed on 05/16/2023 12:32 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	MARY'S CHILD CARE		FACILITY NUMBER:	153805475
ADMINISTRATOR:	ORTIZ, MARIANELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 758-4937
CITY:	WASCO	STATE: CA	ZIP CODE:	93280
CAPACITY:	14	CENSUS: 6	DATE:	05/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Marianela Ortiz		TIME COMPLETED:	01:00 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 05/16/2023, Licensing Program Analysts (LPAs), Jose Penate and Paul Garcia, conducted an unannounced Annual Required Inspection and was met by Licensee, Marianela Ortiz and assistant (Spanish speaking). Days/Hours of operation: Monday-Friday, 05:00 AM to 05:00 PM, or as arranged. LPA toured the home inside and outside and a census was taken. This facility is licensed as a large facility of 14, there must be an additional qualified staff person present anytime the facility goes beyond the ratio for a capacity of eight. LPA toured the facility inside and outside. Current facility sketch was reviewed, and Licensee confirmed that the living room, family room, dining room, kitchen, restroom, and backyard are used for providing care and are accessible to children. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. During inspection LPA observed items stored in high areas (Hutch/Desk) that could potentially fall over on children in care. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. The home has working telephone service and LPA confirmed the phone number is 661-758-4937. LPA and licensee discussed Safe Sleep Regulations. Licensee is aware that cribs and play yards are to be 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. Provider is aware to physically check 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. Individual Infant Sleeping Plan is to be completed for each infant up to 12 months of age upon enrollment. LPA discussed with licensee, Infants up to 12 months of age shall be placed on their backs for sleeping. (Continued on 809-C)

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose Penate	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MARY'S CHILD CARE	FACILITY NUMBER: 153805475
	VISIT DATE: 05/16/2023

NARRATIVE

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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. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensees Mandated Reporter Training was completed on 03/15/2020 and is currently expired. Licensee’s pediatric CPR/First Aid expires on 05/13/2024. A review of records indicates that all employees and/or volunteers have 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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, deficiencies being cited (See LIC809-D).

Exit interview conducted and report was reviewed with Licensee, Marianela Ortiz.

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: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose Penate	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/16/2023 12:32 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MARY'S CHILD CARE	FACILITY NUMBER: 153805475
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(b)

Operation of A Family Child Care Home

(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort. 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. LPA observed items stored on top of the office desk that could potentially fall over children in care. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/26/2023
	Plan of Correction
1 2 3 4	Licensee will remove and declutter area accessible to children in care.

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. Licensee and assistant have expired certification and have not renewed it from the last time it was completed. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/26/2023
	Plan of Correction
1 2 3 4	Licensee and assistant will complete training and submit certification on or before POC date. (5/26/2023)

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: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose Penate	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

LIC809 (FAS) - (06/04)

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