153909890-6-4-2019-04-CC-GRES-BCTNTV-20190604104522

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153909890
Report Date: 06/04/2019
Date Signed: 06/04/2019 10:45:30 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:	GARCIA, DORA FAMILY CHILD CARE		FACILITY NUMBER:	153909890
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	06/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Dora Garcia		TIME COMPLETED:	11:00 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/Random inspection is conducted by Licensing Program Analyst (LPA) Gloria Reyes. LPA met with Licensee, Dora Garcia. The individuals who reside in the home are the licensee, licensee's spouse, licensee's two adult children and licensee's minor child. This facility is licensed for no more than eight children at one time. The home is a two story and the second floor is off-limits to children. A tour of the home, inside and outside, as shown on the facility sketch is provided. The licensee cares for children in the playroom, living room, kitchen, dining room and hall bathroom. Staff and Children were spoken to during visit. There are no "bodies of water" or firearms in this home. Cleaning compounds, medications and other hazardous items are inaccessible to children. Poisons are locked. Fireplaces and open face heaters are screened to prevent access by children. There is a working fire extinguisher, a smoke detector, carbon monoxide detector and there is adequate heating and ventilation for safety and comfort. Where children less than five years old are in care, stairs are fenced or barricaded. There is a working telephone. Adequate supervision is being provided during this visit. Children are supervised when outside in the play area. Capacity as specified on the license is being maintained. Licensee has a current roster of children in care and a copy is secured. Fire drills are conducted and documented with the date and time every six months. 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. Pediatric CPR/Pediatric First Aid are current and expire on 09/20. Licensee has one small dog that is kept outside and is inaccessible to day care children by use of a separate fenced area. Licensee accepts responsibility of any action taken by pet. LPA verified that the required immunizations have been completed by staff. LPA verified that the required Mandated Child Abuse Reporter (AB 1207) training has been completed by staff. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address. (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: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

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: GARCIA, DORA FAMILY CHILD CARE	FACILITY NUMBER: 153909890
	VISIT DATE: 06/04/2019

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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".

Days/Hours of operation: Monday through Friday, 5:00 AM to 5:00 PM.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, 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: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria Reyes	TELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

LIC809 (FAS) - (06/04)

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