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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153905379
Report Date: 03/17/2020
Date Signed: 03/17/2020 01:19:50 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:PLATERO, DOLORES FAMILY CHILD CAREFACILITY NUMBER:
153905379
ADMINISTRATOR:PLATERO, DOLORESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 326-9402
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY:14CENSUS: 6DATE:
03/17/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Dolores PlateroTIME COMPLETED:
01:40 PM
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On this date, 3/17/2020, Licensing Program Analyst (LPA) Ruby Ocegueda conducted a case management inspection for purposes of discussing updates as it relates to the COVID-19 virus. LPA advised licensee that she should continue to the practice frequent cleaning and sanitization of surfaces and practice frequent hand washing as it has been recommended by various health departments. Licensee was provided with the departments website (ccld.ca.gov) and advised to regularly review the website for updates as it pertains to COVID-19 and licensed facilities. LPA provided licensee with most current Provider Information Pin that provided information as to how to proceed with an Informational Call for licensees to participate and ask questions regarding COVID-19 virus. Licensee was advised to contact her local health department should she have questions or concerns regarding anyone in her facility who is showing symptoms of COVID-19 or anyone who might have been exposed to COVID-19. Licensee was also advised to call our Department with this information.

LPA also reviewed Unusual Incidents and form LIC 624 with licensee as well as some examples of what would require an Unusual Incident Report be made to the Department. Licensee understands that if she chooses to close her facility temporarily as a precaution to COVID-19 virus, she must inform the Department and file an Unusual Incident and submit form LIC624.

An exit interview was conducted with licensee Dolores Platero. Per California Code of Regulations, Title 22, Division 12, no deficiency was cited during today's inspection.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2020
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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