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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153907940
Report Date: 12/18/2019
Date Signed: 12/18/2019 12:22:17 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:GUDINO, CECILIA FAMILY CHILD CAREFACILITY NUMBER:
153907940
ADMINISTRATOR:GUDINO, CECILIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 858-0279
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93311
CAPACITY:14CENSUS: 4DATE:
12/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Cecilia GudinoTIME COMPLETED:
12:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Caroline Harris conducted an unannounced annual/random inspection. LPA met with Licensee, Cecilia Gudino. Also present were her son. LPA conducted a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. No pets were observed during today's visit. There are no "bodies of water" or firearms in this home. There were no poisons observed on the premises accessible to children. Cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is inaccessible to children. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. There are no stairs in the home. There is a working telephone and the number was verified. Adequate supervision is being provided during this visit. Children are to be 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. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services.

Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Licensee did not have proof of conducting a fire drill since 5/14/2019. 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.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2019
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: GUDINO, CECILIA FAMILY CHILD CARE
FACILITY NUMBER: 153907940
VISIT DATE: 12/18/2019
NARRATIVE
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Pediatric CPR/First Aid are current and expire on 10/28/20. 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. Business hours are 24 hours per day, 7-days a week.

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 the licensee 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 informed 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: 12/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2019
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: GUDINO, CECILIA FAMILY CHILD CARE
FACILITY NUMBER: 153907940
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/23/2019
Section Cited

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Operation of a Family Child Care Home. All homes shall conduct fire and disaster drills at least once every six months, and document the date, time and how many children present of each drill.

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This requirement was not met as evidenced by the licensee not having proof of conducting a fire drill since 5/14/19. 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: 12/18/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/18/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3