153908506-7-10-2019-04-CC-GRES-BDXPL9-20190710112422

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153908506
Report Date: 07/10/2019
Date Signed: 07/10/2019 11:24:29 AM

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:	MARES, ANGELICA FAMILY CHILD CARE		FACILITY NUMBER:	153908506
ADMINISTRATOR:	MARES, ANGELICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 725-3634
CITY:	DELANO	STATE: CA	ZIP CODE:	93215
CAPACITY:	14	CENSUS: 4	DATE:	07/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Angelica Mares		TIME COMPLETED:	11:45 AM

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	An unannounced annual inspection is being conducted today by Licensing Program Analyst (LPA) Gloria Reyes. LPA met with Licensee, Angelica Mares who is Spanish speaking. Licensee, licensee's adult daughter, and two minor children reside in the home. This facility is licensed as a large facility of 14, there must be an additional qualified staff person present anytime the facility goes beyond the ratio for a capacity of eight. There are no excluded individuals present at this facility. All adults who reside in or work in the facility are criminal record cleared and/or have an exemption. The Pediatric CPR and Pediatric First Aid cards are current and expire on 04/28/19 for both Angelica Mares and Maria Vasquez. Emergency Contact Forms are in each child's file. The Facility Roster is being maintained and a copy is secured. A tour of the home and grounds was completed. There are no bodies of water, no weapons, nor fireplace on the premises. The facility uses central air for heating and cooling and it is adequate. The upstairs is not used and is gated off at the bottom of the stairway and the licensee understands the gate must be in place when children under five years are present during day care hours. The licensee has a working telephone. The backyard is used as the play yard and is fenced. LPA observed a play structure with bark cushioning. The cabinets and/or drawers that have dangerous items in them are inaccessible by plastic safety latch. LPA observed two small pet dogs. One dog is kept inside the home and is inaccessible to day care children and one dog is kept in the backyard which is made inaccessible to children by keeping pet behind a fence. Licensee understands her responsibility to ensure child safety around pets at all times. The fire extinguisher, first aid kit, smoke alarm and carbon monoxide are per regulation. LPA verified that the required immunizations have been completed by staff. LPA verified that the Mandated Reporter Child Abuse (AB 1207) training has been completed by staff. (see next page)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria Reyes	TELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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: MARES, ANGELICA FAMILY CHILD CARE	FACILITY NUMBER: 153908506
	VISIT DATE: 07/10/2019

NARRATIVE

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Fire drills are conducted and documented every month as required. The “off limits” rooms are as follows: the entire second floor, and two downstairs bedrooms and have knob covers or made inaccessible by safety gate. Licensee is aware that any adults providing care and supervision to children or living in the home must have a criminal record clearance. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. During the exit interview, the licensee, Angelica Mares, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility for their mailing address. Licensee does have access to the internet. Licensee is responsible to stay current with regulations and forms through the CCLD web site (www.ccld.ca.gov).

LPA provided information on Safe Sleep guidelines to the licensee. The practice of safe sleep for infants in care was reviewed. LPA provided Licensee with handouts on "Safe Sleep Regulations Concepts", "Individual Infant Sleeping Plan", “Safe Sleep in Child Care” brochure and on "Reducing the Risk of SIDS and SUID in Early Education and Child Care". Licensee was provided a copy of the “Lead Poisoning Facts” brochure. Licensee to refer to PIN 19-04-CCP, for further information. A Spanish forms packet was provided. Business hours are Monday through Saturday, 5:00 AM to 5:00 PM and other hours as arranged.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies are observed today.

Exit interview was conducted with licensee. A copy of this report was provided and discussed. A Notice of Site Visit Form was posted to parent’s board and must be posted for 30 days.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria Reyes	TELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

LIC809 (FAS) - (06/04)

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