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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153807079
Report Date: 12/07/2020
Date Signed: 12/07/2020 11:27:12 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:QUINTERO, OFELIA FAMILY CHILD CAREFACILITY NUMBER:
153807079
ADMINISTRATOR:QUINTERO, OFELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 725-2336
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY:14CENSUS: 2DATE:
12/07/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Ofelia Quintero, LicenseeTIME COMPLETED:
11:45 AM
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On 12/07/2020, LPA Pete Espinoza conducted an unannounced Case Management inspection and met with Ofelia Quintero, Licensee. Licensee is Spanish speaking. Also present were Lolita Quintero (Licensee's adult daughter) and Ubilia Martinez (Assistant). The purpose of today's inspection was to follow-up in a reported incident that occurred on 11/30/2020. Licensee stated there were four (4) children present in the facility at time of incident. LPA reviewed facility records and obtained FirstAid/CPR certification which expires on 01/18/2021. Licensee provided copies of:
Facility Roster (LIC) 9040)
Information and Emergency Information (LIC 700)
Individual Infant Sleeping Plan (LIC 9227)
Consent for Medical Treatment (LIC 627)
Notification of Parent's Rights (LIC 995A)
Sleep log for child in question

Licensee stated Delano Police Department personnel arrived on scene on the day of the incident and photographed the scene and collected items for evidentiary purposes.

Hours of operation are Monday - Saturday 24 hours per day

LPA provided information regarding safe sleep practices and guidelines (National Institute of Child Health and Development Safe Sleep for baby brochure in Spanish.

No deficiencies observed during today's inspection.

LIC 9213 Notice of Site Visit is required to be posted for 30 days.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2020
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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