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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153902023
Report Date: 10/21/2019
Date Signed: 10/21/2019 12:09:03 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:VERA, GUADALUPE FAMILY CHILD CAREFACILITY NUMBER:
153902023
ADMINISTRATOR:VERA, GUADALUPEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 831-3052
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY:14CENSUS: DATE:
10/21/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Guadalup VeraTIME COMPLETED:
12:45 PM
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An unannounced Annual inspection was conducted by Licensing Program Analyst (LPA) Jose Penate. LPA met with Licensee, Guadalupe Vera (Spanish speaking). The individuals who reside in the home are the licensee, licensees' spouse and adult daughter. Licensee stated that she has not cared for any children, other than her own for approximately four years. 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. Licensee stated to LPA that she wishes to apply for the small license due to her not having children currently enrolled into her program. LPA toured the facility inside and outside. The areas of the home that day care children will have access to is the Day Care Room, day care restroom, kitchen, dining room, living room, and back yard. No bodies of water on site. No firearms or ammunition are in the home. Storage areas for detergents, cleaning compounds, medications and other items which could pose a danger to children are stored where they are inaccessible to children. Poisons are locked. The home has a fireplace that is not used during daycare hours. Fire extinguisher, smoke detector, and carbon monoxide detector are operable and in place. The home is kept clean and orderly with heating and ventilation for safety and comfort. There are no stairs in this home. The home provides safe toys, play equipment, and materials. Licensee has a pet (1 dog). When temporarily absent from the home, the licensee arranges for a substitute adult to care for and supervise children in her absence. The licensee maintains capacity specified on the license. Each child has safe, healthful, and comfortable accommodations, furnishings, and equipment. There are no excluded individuals in the home. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to home or having contact with children in care. All individuals subject to a criminal record review have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home. License currently does not have fee's paid current, licensee stated that she will be sending her fee's by mail on 10/25/19.

Continued on LIC 809-C

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2019
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: VERA, GUADALUPE FAMILY CHILD CARE
FACILITY NUMBER: 153902023
VISIT DATE: 10/21/2019
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The licensee and other personnel as specified have completed training on preventive health practices including Pediatric CPR and Pediatric First Aid is current and expires on 12/23/2019. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. LPA reviewed with licensee the requirements for staff related to the Mandated Child Abuse Reporter training required by staff. The website may be found at: (www.mandatedreporterca.com). Licensee is Spanish speaking and it in currently not available, once Mandated Reporter Training is offered in Spanish licensee must complete. LPA provided information on Safe Sleep guidelines to the licensee. The practice of safe sleep for infants in care was reviewed. LPA provided Licensee with handouts on "Safe Sleep Regulations Concepts", on "Individual Infant Sleeping Plan" and on "Reducing the Risk of SIDS and SUID in Early Education and Child Care". Licensee was provided a copy of the “Lead Poisoning Facts” brochure. Licensee to refer to PIN 19-04-CCP, for further information.

Planned hours of operation are 7 days a week 24 hours a day with no continuous care over 23 1/2 hours.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies cited.

Exit interview was conducted with licensee. A copy of this report was provided and discussed.

A Notice of Site Visit Form was posted to parent’s board and must be posted for 30 days.

SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2019
LIC809 (FAS) - (06/04)
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