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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153905353
Report Date: 02/26/2020
Date Signed: 02/26/2020 01:06:30 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:BETANCOURT, ROSALBA FAMILY CHILD CAREFACILITY NUMBER:
153905353
ADMINISTRATOR:BETANCOURT, ROSALBAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 667-3397
CITY:WASCOSTATE: CAZIP CODE:
93280
CAPACITY:14CENSUS: 3DATE:
02/26/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Rosalba BetancourtTIME COMPLETED:
01:20 PM
NARRATIVE
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Licensing Program Analyst (LPA), Rene Mancinas JR, conducted an unannounced annual inspection and met with Licensee, Rosalba Betancourt, whom is Spanish speaking. LPA Mancinas provided interpretation services. LPA toured the home inspecting areas accessible to children and a census was taken. Licensee confirmed that the kitchen, dining room, one of the two living rooms, children’s bathroom, and backyard are used for providing care and are accessible to children. This is a two-story home. There are no swimming pools or other bodies of water on the premises. There are no firearms or ammunition present at this facility. Safe toys and play equipment are observed. No poisons were observed during inspection. There is a fireplace at this home that is blocked off and made inaccessible to children in care. There is working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are pets at this home. Licensee understands the responsibility of any action taken by pets involving day care children. Capacity as specified on the license is being maintained. A review of records indicates that immunization records are in file for children. Licensee had a current roster of children in care and maintains emergency information and forms as required. Licensee has a working telephone and the above telephone number was verified. Adequate supervision is being provided during this visit. 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. Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and notification of ‘Parents Rights’ poster are in an area readily accessible for parents/guardians to review.

Hours of operation are Sunday through Saturday; 24/7 hours/days. Licensee understands she cannot care for a single child for more than 23 ½ continuous hours.

(Continued on 809-C)

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
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 6
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: BETANCOURT, ROSALBA FAMILY CHILD CARE
FACILITY NUMBER: 153905353
VISIT DATE: 02/26/2020
NARRATIVE
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Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide these services. The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which provides access to Provider Information Notices (PINS), Quarterly Updates, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, and Licensing Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies were observed and are being cited today. (See 809-D). Appeal rights were provided.

[Deficiencies observed]

During today’s inspection of the backyard, which is accessible to day care children, LPA observed miscellaneous gardening tools/supplies, and other hazardous items. LPA observed 3 pruning shears, two shovels, a wheelbarrow, a gasoline tank, two propane tanks, an electric chainsaw, and a hand saw. When questioned, Licensee stated she was gardening and planting prior to LPA arriving at the facility. LPA informed that such hazardous items need to be made inaccessible when not in use. This is an immediate risk to the health, safety, and personal rights of children in care.

During today’s inspection of facility files review, Licensee could not produce documentation of fire/disaster drills being conducted at the home, at least once every six months as required per regulations. Licensee stated she was conducting and documenting fire drills, but misplaced the documentation. This is a potential risk to the health, safety, and/or personal rights of children in care.

During inspection of accessible areas in the home, LPA did not observe a safety gate fixed/secured at the bottom of the stairs, as required per regulations. This is a two-story home and LPA informed Licensee that it is a requirement per regulation to have a safety gate fixed/secured at the bottom of the stairs, in order to make the staircase and second floor of the home in accessible to children in care. Licensee stated she had a gate there but removed it as she now uses the [same] gate to split the two living rooms of the home, making one of the living rooms inaccessible and the other accessible. This is a potential risk to the health, safety, and personal rights of children in care. (Continued on 809-C)

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: BETANCOURT, ROSALBA FAMILY CHILD CARE
FACILITY NUMBER: 153905353
VISIT DATE: 02/26/2020
NARRATIVE
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During today’s inspection of facility files review, Licensee could not produce proof of required immunizations (Pertussis, Measles, Flu). LPA informed that Flu vaccine is required annually, but is optional, so long as the individual in question provides a written statement (signed and dated) opting out of Flu shot for given year. This is a potential risk to the health, safety, and/or personal rights of children in care.

[End of deficiencies observed]

Upon receipt of this report, facility shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A completed signed copy of the LIC 9224 will need to be completed by each parent for each child in care.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Inspection is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 6 of 6
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: BETANCOURT, ROSALBA FAMILY CHILD CARE
FACILITY NUMBER: 153905353
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/28/2020
Section Cited

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Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement was not met as
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evidenced during today's inspection. (See 809-C for further details). This is an immediate risk to the health, safety, and/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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: BETANCOURT, ROSALBA FAMILY CHILD CARE
FACILITY NUMBER: 153905353
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2020
Section Cited

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(A)Each family child care home shall conduct fire drills and disaster drills at least once every six months.
(1) The licensee shall document the drills, including the date and time of each drill. This requirement was not met as evidenced
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during today's inspection of facility files. (See 809-C for further). This is a potential risk to health, safety, and/or personal rights of children in care.
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Type B
03/02/2020
Section Cited

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Where children less than five years old are in care, stairs shall be fenced or barricaded. This requirement was not met as evidenced during today's inspection. (See 809-C for further).
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This is a potential risk to health, safety, and/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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: BETANCOURT, ROSALBA FAMILY CHILD CARE
FACILITY NUMBER: 153905353
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/20/2020
Section Cited

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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.
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This requirement was not met as evidenced during today's inspection of facility files. (See 809-C for further).This is a potential risk to health, safety, and/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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene MancinasTELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 5 of 6