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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153903811
Report Date: 07/02/2019
Date Signed: 07/02/2019 02:07:35 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:ESCOBAR, SILVIA FAMILY CHILD CAREFACILITY NUMBER:
153903811
ADMINISTRATOR:ESCOBAR, SILVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 858-0650
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:14CENSUS: 9DATE:
07/02/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Silvia EscobarTIME COMPLETED:
02:30 PM
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Licensing Program Analysts (LPAs) Caroline Harris and Candis Rodriguez conducted an unannounced annual/random inspection. LPAs met with Licensee Silvia Escobar. Also present were her assistant. LPAs conducted a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. Licensee has one dog that is kept in a dog kennel in an off limits area. Licensee is aware of the safety of children around animals. Licensee takes responsibility for any action taken by pets. There are no firearms in this home. Swimming pool is fenced per regulation. Licensee has a play yard for the children, accessible with numerous toys. There were no poisons observed on the premises accessible to children. During the inspection, the LPA's observed Lysol, Febreeze, shampoo and conditioner in the bathroom that was accessible to children. LPA's also observed five different drawers in the kitchen that had sharp knives, pointed scissors, batteries, super glue and numerous types of tools such as screw drivers, screws and pliers in them. These drawers had child proof devices on them, however they were not working. There is no fireplace. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. Stairs are barricaded when children under age 5 years old are present. There is a working telephone and the number was verified. Adequate supervision is being provided during this visit. Capacity as specified on the license is being maintained. Licensee did not have a current roster of the children. Licensee does maintain documentation of immunizations for the children. Licensee also maintains documentation of immunizations against pertussis, measles and influenza for herself and staff. Incidental Medical Services (IMS) policy was discussed. During the annual inspection Licensee stated they will NOT be providing Incidental Medical Services (IMS) at this time.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 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: ESCOBAR, SILVIA FAMILY CHILD CARE
FACILITY NUMBER: 153903811
VISIT DATE: 07/02/2019
NARRATIVE
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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. Pediatric CPR/First Aid are current and expire on 3/25/20. 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. Days and hours of operation are Monday – Friday; 6:30 AM – 6:00 PM.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are found (see next page): 809 D



Exit interview was conducted with Licensee. LPA reviewed with licensee the Mandated Child Abuse Reporter Training, which her and her staff have completed. LPA also provided the licensee with information on Safe Sleep requirements and reviewed the regulation changes. Information on Lead Poisoning was also provided to the licensee and she was informed that copies need to be provided to all current parents and any future parents of children enrolled along with posting the information on the parent board. LPA discussed with the licensee about the Community Care Licensing website: www.ccld.ca.gov. and discussed with licensee about the new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Updates that inform licensees of new legislation and regulations. Licensee was advised that forms and updated information may be obtained on the CCLD website and was also advised that it is her responsibility to stay current with regulations.

A copy of this report was provided and discussed along with appeal rights. THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
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: ESCOBAR, SILVIA FAMILY CHILD CARE
FACILITY NUMBER: 153903811
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/09/2019
Section Cited
CCR
102417(g)(8)
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Operation of a Family Child Care Home. All homes shall have a current roster of the children. This requirement was not met as evidenced by the licensee not having a roster available for review. This is a possible risk to the health, safety or personal rights of children in care.
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Licensee shall send a current roster of children in care to the CCL office by 7/9/19.
Type B
07/09/2019
Section Cited
CCR
102417(g)(4)
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Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger to children shall be stored where they are inaccessible to children.
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Licensee removed the items during the visit. Licensee to replace child safety latches on any drawers and cabinets that contain hazardous items by the given due date of 7/9/19.
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This requirement was not met as evidenced by the LPA's observations as further discussed in the 809. This is a possible risk to the health, safety or personal rights of children in care.
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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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3