153807696-7-27-2021-04-CC-AGIN-C5BQU3-20210727122804

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153807696
Report Date: 07/27/2021
Date Signed: 07/27/2021 12:28:23 PM

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:	CARDONA, EILEEN FAMILY CHILD CARE		FACILITY NUMBER:	153807696
ADMINISTRATOR:	CARDONA, EILEEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 323-2784
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93305
CAPACITY:	14	CENSUS: 9	DATE:	07/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Eileen Cardona		TIME COMPLETED:	12:45 PM

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On 07/27/21 Licensing Program Analysts (LPAs), Araceli Gibson and Diana Mercado conducted an unannounced 1 Year Required Inspection and was met by Eileen Cardona Licensee, and assistant Bertha Florez. Days and hours of operation are Monday through Sunday, but less than 24 hours.

LPA toured the home inside and outside and a census was taken 9 children total. Current facility sketch reviewed, and Licensee confirmed that the kitchen, bathroom and living room, 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 child safety gates. Licensee does have one small dog that will be accessible to day-care children present. Licensee is aware of child safety around pets and accepts responsibility for any action taken by pets. LPA advised the importance of supervision at all time. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible by means of safety locks on cabinets and drawers.

There is a working smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has a working telephone service and LPA confirmed the phone number is (661) 323-2784.

Currently Licensee has no infants in care. LPA discussed Safe Sleep Regulations with licensee. There is 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 was given a log for 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 infant in a separate room. Infants up to 12 months of age are placed on their backs for sleeping.

Continue 809C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Araceli Gibson	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

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: CARDONA, EILEEN FAMILY CHILD CARE	FACILITY NUMBER: 153807696
	VISIT DATE: 07/27/2021

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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 and there are no hazards to children present. 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. Licensee’s Mandated Reporter Training is current was previously completed on 05/28/2020. Licensee’s pediatric CPR/First Aid is current it expires on 05/23/23. A review of records indicates that Licensee is missing MMR immunization documentation for herself and her assistant’s immunization's. LPA discussed 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.

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 deficiencies 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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Araceli Gibson	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

LIC809 (FAS) - (06/04)

Page: 2 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: CARDONA, EILEEN FAMILY CHILD CARE	FACILITY NUMBER: 153807696
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/27/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/18/2021 Section Cited	1 2 3 4 5 6 7	(a)(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by observation and records review conducted during today’s inspection. Upon inspection the licensee was unable to provide LPA proof of MMR Vaccine or immunizations for assistants.This poses a potential risk to the health and safety for children in care.	8 9 10 11 12 13 14
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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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Araceli Gibson	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

LIC809 (FAS) - (06/04)

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