153902258-3-24-2022-04-CC-TMAZ-CCTTP4-20220324145339

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153902258
Report Date: 03/24/2022
Date Signed: 03/24/2022 02:53:45 PM

Document Has Been Signed on 03/24/2022 02:53 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	FLORES, ANGELICA FAMILY CHILD CARE		FACILITY NUMBER:	153902258
ADMINISTRATOR:	FLORES, ANGELICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 333-7771
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93313
CAPACITY:	14	CENSUS: 10	DATE:	03/24/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Angelica Flores		TIME COMPLETED:	03:00 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 3/24/2022, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced annual inspection and met with Licensee, Angelica Flores (Spanish/English Speaking). Assistant Maria Diza was also present. A tour of the home was conducted, and a census was taken. Current facility sketch reviewed, and Licensee confirmed the living room, play room, dining/kitchen area, the hall bathroom and the fenced backyard are used for providing care and are accessible to day care children. All other rooms are off-limits and are made inaccessible by use of spinner knobs. Medications and other hazardous items were inaccessible to children. LPA did not observe any poisons in the home. The fire extinguishers, smoke detectors, and carbon monoxide detector met Community Care Licensing (CCL) regulations. Heating/cooling and ventilation was sufficient for safety and comfort. There were no stairs in the home. Safe toys and play equipment were observed. Adequate supervision was being provided during this inspection. Staff-child ratios were maintained. LPA discussed the safe sleep regulations with licensee, Angelica Flores and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. The outdoor play area in the backyard is fenced and there are no hazards to day care children. Licensee ensures that children in care are supervised at all times. Licensee has 2dogs that are inaccessible. Licensee is aware of child safety around pets and accepts responsibility for any action taken by pets. There were no swimming pools, bodies of water, or firearms on the premises. Continued on LIC809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

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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Document Has Been Signed on 03/24/2022 02:53 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: FLORES, ANGELICA FAMILY CHILD CARE	FACILITY NUMBER: 153902258
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(a)

Immunizations

(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, five of the ten children present were missing immunization records. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/15/2022
	Plan of Correction
1 2 3 4	Licensee agreed to obtain the missing immunization records for children: #3, #5, #6, #9, and #10. Licensee to submit in writing to LPA Theresa Marquez when she receives the missing immunization records.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

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: FLORES, ANGELICA FAMILY CHILD CARE	FACILITY NUMBER: 153902258
	VISIT DATE: 03/24/2022

NARRATIVE

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A sample of children’s records contained all emergency information specified by regulation. A review of records indicated Licensee has proof of required immunization (Pertussis/Measles and a written declaration declining flu shot. Licensee's Mandated Reporter Training was completed on 1/14/2022 . Licensee's pediatric CPR and First Aid expires on 6/25/2023.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
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.

Hours of operation are Monday through Friday 7:00 AM to 9:00 PM.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiencies were found; Five of the 10 children present are missing immunization records. (see LIC809-D).
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

An exit interview was conducted and report was reviewed with the Angelica Flores. A copy of Appeal Rights and the Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022

LIC809 (FAS) - (06/04)

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