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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153909344
Report Date: 06/17/2019
Date Signed: 06/17/2019 11:03:03 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:HILL, JENNIFER FAMILY CHILD CAREFACILITY NUMBER:
153909344
ADMINISTRATOR:HILL, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 827-7986
CITY:SHAFTERSTATE: CAZIP CODE:
93263
CAPACITY:14CENSUS: 4DATE:
06/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jennifer HillTIME COMPLETED:
11:15 AM
NARRATIVE
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An unannounced annual/random inspection is conducted by Licensing Program Analyst (LPA) Gloria Reyes. LPA met with Licensee, Jennifer Hill. The individuals residing in the home are the licensee, licensee's spouse, John Hill and licensee's adult child. LPA toured the facility inside and outside. The accessible rooms are the living room, dining room, kitchen, children's playroom, second (daughter's) bedroom (napping only), and hallway bathroom. No bodies of water on site. No firearms or ammunition are in the home. Storage areas for detergents, cleaning compounds, medications and other items which could pose a danger to children are stored where they are inaccessible to children. Poisons are locked. Fireplaces and open face heaters are screened to prevent access by children. Fire extinguisher, smoke detectors, and carbon monoxide detector are operable and in place. The home is kept clean and orderly, with heating and ventilation for safety and comfort. The home provides safe toys, play equipment, and materials. The licensee is present in the home and ensures that children in care are supervised at all times. When temporarily absent from the home, the licensee arranges for a substitute adult to care for and supervise children in her absence. The licensee maintains capacity specified on the license. Each child has safe, healthful, and comfortable accommodations, furnishings, and equipment. The home has a current roster of the children and a copy is secured. The home conducts fire and disaster drills at least once every six months, and documents the date and time of each drill. Licensee documents immunizations and maintains and updates records for children in care. The backyard will be off-limits. The enclosed front yard is used for play and children are to be supervised at all times. LPA verified that required immunizations have been completed by staff. LPA verified that the required Mandated Child Abuse Reporter (AB1207) training has been completed by licensee. (see next page)
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019
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: HILL, JENNIFER FAMILY CHILD CARE
FACILITY NUMBER: 153909344
VISIT DATE: 06/17/2019
NARRATIVE
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Licensee has one dog that is kept in a crate and is accessible to day care children. Licensee is aware of children safety around pet and accepts all liability of any action taken by pet dog. 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. There are no excluded individuals in the 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 home or having contact with children in care. All individuals subject to a criminal record review have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home. The licensee and other personnel as specified have completed training on preventive health practices. However, Pediatric CPR and Pediatric First Aid expired on 08/18. 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

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.
Hours of Operation: Monday through Friday, 7:00 AM to 6:30 PM.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, a deficiency is cited on the attached LIC 809D.

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

SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019
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: HILL, JENNIFER FAMILY CHILD CARE
FACILITY NUMBER: 153909344
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/19/2019
Section Cited
CCR
102416(c)
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The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
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Licensee agrees to schedule a class and provide LPA with a copy of updated card by due date.
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This requirement was not met as evidenced by today's inspection, LPA Reyes observed Licensee expired CPR & First Aid card expired on 08/18. This is a potential risk to the health, safety, and 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: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019
LIC809 (FAS) - (06/04)
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