153902695-9-12-2019-04-CC-RMAS-BFXSWY-20190912141507

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153902695
Report Date: 09/12/2019
Date Signed: 09/12/2019 02:15:12 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:	MENA, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	153902695
ADMINISTRATOR:	MENA, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 240-5079
CITY:	WASCO	STATE: CA	ZIP CODE:	93280
CAPACITY:	14	CENSUS: 8	DATE:	09/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	Maria Mena		TIME COMPLETED:	12:45 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	Licensing Program Analysts (LPAs), Rene Mancinas JR and Diane Mercado, conducted an unannounced annual inspection. LPAs met with Licensee, Maria Mena, whom is Spanish speaking. LPAs conducted a tour of the home and inspected areas accessible to day care children. There are no pets at this home. There are no "bodies of water" or firearms in this home. No poisons were observed during today’s inspection. Cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is inaccessible to children. There is a working fire extinguisher, smoke detector, and adequate heating and ventilation for safety and comfort. There is a working telephone and number was verified. Adequate supervision is being provided during this visit. Children are supervised when outside in the unfenced play area. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee maintains documentation of immunizations for the children. Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Fire drills are conducted and documented with the date and time every six months. Licensee is aware that children are never to be left in parked vehicles. 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. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Licensee maintains proof of required immunizations (TB/Measles/Pertussis/Flu [required annually, but optional if written statement provided yearly]) and were verified by LPA during today’s inspection. Pediatric CPR/First Aid are current and expire on 04/11/2020. License completed Mandated Reporter Training for Child Care Providers per Assembly Bill 1207 on 04/28/2018. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. Incidental Medical Services (IMS) policy was discussed. (Continued on 809-C)

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2019

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: MENA, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 153902695
	VISIT DATE: 09/12/2019

NARRATIVE

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LPA informed Licensee of Safe Sleep practices for infants and how to provide Safe Sleep environments. LPA informed Licensee to visit the Department’s website (www.ccld.ca.gov) for updates and changes related to licensing regulations and procedures.

Hours of operation are Monday – Friday; 05:00am -05:00pm.

LPA & licensee discussed the Community Care Licensing website. LPA and licensee discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register for PINs.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited. Notice of Site to be posted for 30 days.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2019

LIC809 (FAS) - (06/04)

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