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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153909362
Report Date: 01/23/2020
Date Signed: 01/23/2020 01:40:09 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:BENITEZ-LOPEZ, MARTHA FAMILY CHILD CAREFACILITY NUMBER:
153909362
ADMINISTRATOR:BENITEZ-LOPEZ, MARTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 444-1199
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY:14CENSUS: 8DATE:
01/23/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Martha Benitez-LopezTIME COMPLETED:
01:45 PM
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An unannounced Annual inspection was conducted by Licensing Program Analyst (LPA) Jose Penate. LPA met with Licensee, Martha Benitez-Lopez and her assistant. 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. LPA toured the facility inside and outside. The areas of the home that day care children will have access to is the living room, kitchen, dining room, hallway bathroom, and back yard. 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. There is fireplace in the home and it is inaccessible to daycare children, licensee has placed wooden bookshelf in front. Fire extinguisher, smoke detector, and carbon monoxide detector are operable and in place. The home provides safe toys, play equipment, and materials. Licensee has two large dogs and two small dogs that are kept in areas inaccessible to children. Licensee is aware of the safety of children around animals. 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. The home conducts fire and disaster drills every month, and documents the date and time of each drill. Licensee documents immunizations and maintains and updates records for children in care. 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. Mandated reporter was completed on 06/06/2018.

Continued on LIC 809-C

SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020
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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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: BENITEZ-LOPEZ, MARTHA FAMILY CHILD CARE
FACILITY NUMBER: 153909362
VISIT DATE: 01/23/2020
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LPA spoke with licensee regarding her off limit rooms and based off of pre licensing facility sketch, licensee was approved to have the entire home accessible to children. On todays inspection licensee stated that she no longer wants to have any other rooms approved besides her master bedroom. Licensee also stated that she no longer wants to have second restroom on the license, she only allows the children to use the hallway restroom. LPA advised licensee to only place spinner locks on the doors she wishes to have off limits. LPA instructed licensee to complete a new facility sketch and submit it to CCLD to have on file.

The licensee and other personnel as specified have completed training on preventive health practices including Pediatric CPR and Pediatric First Aid is current and expires on 04/17/2021. Incidental Medical Services (IMS) policy was discussed. 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. 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", on "Individual Infant Sleeping Plan" 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


Planned hours of operation are Mondays through Friday 7:00AM to 5:30PM and/or as arranged.



Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiencies cited.

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: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2020
LIC809 (FAS) - (06/04)
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