153910248-12-28-2021-04-CC-NLOI-CA5UF4-20211228143206

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153910248
Report Date: 12/28/2021
Date Signed: 12/28/2021 02:32:17 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:	FORD, SHANITA FAMILY CHILD CARE		FACILITY NUMBER:	153910248
ADMINISTRATOR:	FORD, SHANITA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 670-4031
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93309
CAPACITY:	14	CENSUS: 8	DATE:	12/28/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Shanita Ford		TIME COMPLETED:	02:45 PM

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 1 Year Required inspection was conducted today by Licensing Program Analyst, Norma Lomeli. Present during the inspection was licensee, her two assistants and eight day-care children who were watching a children’s movie in the day care room. Licensee and her minor child reside in the home. Background clearances were discussed and licensee signed LIS531 indicating all adults residing and/or providing care and supervision have a criminal record clearance or exemption. The licensee and licensee’s assistants have current pediatric CPR and First Aid. Licensee’s expires on April 10, 2023. Licensee’s Assistant, Charisma Ramos expires on April 16, 2022 and Licensee’s Assistant, Isamar Martinez expires on June 5, 2023. Preventative Health Practice was completed and confirmed at pre-licensing inspection The home is clean and orderly, with heating and ventilation for safety and comfort. Observed children size furniture, bean bags and couches for the day care children. Also observed safe toys, play equipment and materials. A current roster of children in care is maintained. Verified that immunizations records are maintained and license updates records for children in care. Licensee provides a copy of Parent’s Rights to all parents and/or child’s representative. The licensee ensures that children in care are supervised at all times. Fire and disaster drills are conducted at least once every six months, and documented with the date and time. Licensee states there are no firearms, ammunition or poisons in the home. (Continued on LIC809-C):

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021

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: FORD, SHANITA FAMILY CHILD CARE	FACILITY NUMBER: 153910248
	VISIT DATE: 12/28/2021

NARRATIVE

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Detergents, cleaning compounds, medications and other items which could pose a danger to children are stored where they are inaccessible to children.
There is a fireplace in the living room that licensee states it is not used during day-care hours. Licensee is advised that fireplaces are to be screened when in use to prevent access by children.
Facility has required fire extinguishers and smoke detectors that meet State Fire Marshall standards. Facility has a working carbon monoxide detector that meets the statutory requirements.
No bodies of water observed in or on the premises.
Licensee states she maintains licensed capacity at all times.
Licensee is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a).
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
SB 792 Implementation for required immunizations effective September 1, 2016 was discussed.

LPA & licensee discussed the Community Care Licensing website: LPA and licensee discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

(Continued on LIC809-C):

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021

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: FORD, SHANITA FAMILY CHILD CARE	FACILITY NUMBER: 153910248
	VISIT DATE: 12/28/2021

NARRATIVE

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Hours or operation are Monday through Friday from 6:00 AM to 6:00 PM and as arranged; less than 24 hours. Licensee is reminded of inspection authority by employees of the Department at any time, with or without advance notice. Licensee understands children may not be left in parked vehicles. When temporarily absent from the home, the licensee arranges for a substitute adult to care for and supervise children in her/his absence.

During exit interview, LPA observed licensee post the Notice of Site Visit on parent’s board and understands it must remain posted for 30 days and retain evaluation report for 3 years.

In the areas that were evaluated no deficiencies were observed at the time of the inspection.

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2021

LIC809 (FAS) - (06/04)

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