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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910691
Report Date: 05/15/2019
Date Signed: 05/15/2019 12:29:24 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:MOLINA, LAURA FAMILY CHILD CAREFACILITY NUMBER:
153910691
ADMINISTRATOR:MOLINA, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 549-2424
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93306
CAPACITY:14CENSUS: 2DATE:
05/15/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Laura MolinaTIME COMPLETED:
12:45 PM
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An unannounced Case Management (90-day post-license) inspection was conducted today by Licensing Program Analyst (LPA) Gloria Reyes. LPA met with Licensee, Laura Molina. The individuals who reside in the home are the licensee and licensee's boyfriend. This is a two story home with child safety gate located at the bottom of the stairs making the second floor off-limits to day-care children. 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 and a census was taken. The areas of the home that day-care children will have access to are the entire first level minus the garage.
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 including Pediatric CPR and Pediatric First Aid. Licensee is scheduled to recertified her cards on 05/25/19 and will send a copy of cards to licensing. Licensee stated that there are no firearms in the home nor bodies of water. LPA observed a 2A-10-BC fire extinguisher, smoke detector, carbon monoxide detector and a first aid kit. A disaster drill is maintained. A Child Roster is maintained, and a copy will be provided to CCLD. Children's files were reviewed. Required forms are posted. Licensee has completed the required immunizations and the required Mandated Child Abuse Reporter (AB 1207) training. (see next page)
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019
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 2
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: MOLINA, LAURA FAMILY CHILD CARE
FACILITY NUMBER: 153910691
VISIT DATE: 05/15/2019
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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 Days/Hours of Operation: Monday through Friday from 7:00 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 JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Gloria ReyesTELEPHONE: (559) 341-4471
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2