153909362-10-20-2021-04-CC-AGIN-C7YRD8-20211020125531

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153909362
Report Date: 10/20/2021
Date Signed: 10/20/2021 12:56:25 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 CARE		FACILITY NUMBER:	153909362
ADMINISTRATOR:	BENITEZ-LOPEZ, MARTHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 444-1199
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93304
CAPACITY:	14	CENSUS: 4	DATE:	10/20/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Martha Benitez Lopez		TIME COMPLETED:	01:05 PM

NARRATIVE

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On 10/20/21 Licensing Program Analyst (LPA), Araceli Gibson conducted an unannounced One Year Required Inspection and was met by Licensee, Martha Benetiz Lopez . Days and hours of operation are Monday through Saturday 7:00 AM to 5:30 PM.

LPA toured the home inside and outside and a census was taken of 4 children in care. Licensee confirmed that the living room, kitchen, bathroom, dining room, and back yard are used for providing care and are accessible to children. During today's inspection Licensee requested to remove access for the Master Bed room which was made inaccessible to children by a spinner knob. Licensee made changes to the facility sketch and was signed by the Licensee. All other rooms are off-limits and made inaccessible by use of locks and spinner knobs. There is no swimming pool or other bodies of water on the premises. No firearms on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, Scissors and other hazardous items were observed on the counter tops and outdoor spaces accessible to children see (809D).

There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in the home. A fireplace located in the living room is made inaccessible to children by a shelf blocking access. Fireplace is not in use during day care hours. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (661) 444-1199.

There are no infants in care. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care if Licensee decides to enroll an infant. Cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Infants up to 12 months of age are placed on their backs for sleeping. Licensee understands the use of the Infant Sleep LIC 9227 form. Continue 809C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Araceli Gibson	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/20/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(4)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above Detergents, Lysol, scissors and clutter on top of kitchen counters and in outdoor space accessible to children which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/29/2021
	Plan of Correction
1 2 3 4	Licensee agreed to organize and put detergents, hazzardous items up high by POC date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Araceli Gibson	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021

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: 10/20/2021

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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced. LPA observed and discussed best practice to do a brief clean up weekly to assure outdoor areas are clean and safe for children to use. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with the immunizations. Licensee, completed the Mandated Reporter Training on 2/05/2020. Licensees’ pediatric CPR/First Aid expires on 04/17/23. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. During file review LPA was not able to verify LIC 508 for all adults in in the home. There are no excluded individuals present at this home.

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. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Araceli Gibson	TELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021

LIC809 (FAS) - (06/04)

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