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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153807282
Report Date: 02/13/2020
Date Signed: 02/13/2020 10:06:54 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:WILLIAMS, BLANCHE FAMILY CHILD CAREFACILITY NUMBER:
153807282
ADMINISTRATOR:WILLIAMS, BLANCHEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 321-0640
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY:14CENSUS: 1DATE:
02/13/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Blanche Williams - Licensee TIME COMPLETED:
10:20 AM
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On 02/13/20, an unannounced Annual/Random Inspection was conducted by Licensing Program Analyst (LPA) Jessika Thompson. LPA with met with Licensee Blanche Williams and a census was taken. A tour of the facility was made. Background clearances were discussed, and licensee confirmed all adults residing and/or providing care and supervision have a criminal record clearance. Licensee has current pediatric CPR and First Aid that expire on 06/02/20. Off-limit rooms are made inaccessible by use of locked doors. The home is clean and orderly, with heating and ventilation for safety and comfort. Safe, healthful, and comfortable accommodations, furnishings, toys and equipment were observed. LPA confirmed Licensee maintains and updates the facility’s Children’s Roster (LIC9040). LPA confirmed Licensee maintains Notification of Parents’ Rights (LIC995A), Proof Consent for Emergency Medical Treatment (LIC627), and immunization records for children in care. Licensee ensures that children in care are supervised at all times. Fire and disaster drills are conducted at least once every six months, and documented with the date and time. There are no firearms or bodies of water at this residence. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are stored where they are inaccessible to children. Facility has required fire extinguisher and smoke detector, both meet State Fire Marshall standards. Facility has one functioning carbon monoxide detector that meets statutory requirements. Licensee understands children may not be left in parked vehicles. Safe sleep practices for infants was discussed and reviewed. Lead safety was discussed, and LPA provided Licensee with a brochure. Licensee understands that lead safety information must also be provided to parents and/or authorized representatives of children in care. Provider Information Notices were discussed, and LPA encouraged Licensee to subscribe to receive updates via email. Licensee is aware that forms and updated information may be obtained on the Department’s website (www.ccld.ca.gov). Licensee has proof of Child Abuse Mandated Reporter training, completed 10/08/18. Licensee was advised that this certification must be renewed every two years. Licensee understands that it is her responsibility to stay current with regulations. Licensee is urged to visit the U.S. Consumer Product Safety Commission web page at www.cpsc.gov to ensure that equipment purchased for the day care have not been recalled (Continued on LIC809-C).
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
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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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: WILLIAMS, BLANCHE FAMILY CHILD CARE
FACILITY NUMBER: 153807282
VISIT DATE: 02/13/2020
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Incidental Medical Services (IMS) are not currently being provided. Licensee was advised that if/when any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Licensee was advised that the Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).


Hours of operation are Monday through Friday from 7:30 AM to 7:30 PM and as arranged; less than 24 hours. Licensee is reminded of inspection authority by employees of the Department at any time, with or without advance notice.

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

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 02/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020
LIC809 (FAS) - (06/04)
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