153910711-3-17-2020-04-CC-JTHN-BMSRYJ-20200317132626

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153910711
Report Date: 03/17/2020
Date Signed: 03/17/2020 01:26:35 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:	PRUNEDA, DORA FAMILY CHILD CARE		FACILITY NUMBER:	153910711
ADMINISTRATOR:	PRUNEDA, DORA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 910-4394
CITY:	SHAFTER	STATE: CA	ZIP CODE:	93263
CAPACITY:	14	CENSUS: 8	DATE:	03/17/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Maria Chavez - Assistant		TIME COMPLETED:	01:30 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	On 03/17/20, Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced annual inspection. LPA with met with the licensee’s assistant, Maria Chavez, and a census was taken. Also present was Adult #1, who was participating in craft time with children in care. Adult #1 is not criminal background cleared; therefore, LPA informed Ms. Chavez that Adult #1 is not permitted to provide childcare services at the Family Child Care Home (FCCH). LPA spoke to Licensee via telephone, as she was not present for the entirety of today's inspection. Licensee stated that Adult #1 had assisted in providing care to children for five days without clearance. Adult #1 vacated the premises upon request. There were seven children present during today's inspection. As none of the children present were school age, and there was only one qualified child care provider, Ms. Chavez was informed that the facility was operating out of ratio. Additionally, LPA confirmed that the licensee’s daughter, Adult #2, who was not present during today's inspection, has been residing at the FCCH for several months without criminal background clearance. A tour of the facility was made and LPA verified that Ms. Chavez has current pediatric CPR and First Aid, which expires 01/04/22. Accessible areas of the home are the living room, dining room, and hallway bathroom. Off-limit rooms are made inaccessible by use of child safety gates. The home is clean and orderly, with heating and ventilation for safety and comfort. Safe, healthful, and comfortable accommodations, furnishings, toys and equipment were observed. Licensee has one dog that is inaccessible to children, as the pet is caged in the backyard when children are at play in surrounding areas. A current roster of children in care is maintained. LPA verified that immunization records are maintained, and licensee updates records for children in care. Licensee provides a copy of Parent’s Rights to all parents and/or child’s representatives. Fire and disaster drills are conducted at least once every six months and are documented with the date and time. Ms. Chavez stated there are no firearms or bodies of waters at this residence, nor did LPA observe the aforementioned. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are stored where they are inaccessible to children. Facility has required fire extinguisher, smoke detector, and carbon monoxide detector, all of which meet statutory requirements. Safe sleep practices for infants was discussed; LPA provided Ms. Chavez with a corresponding handout (Continued on LIC809-C).

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2020

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 3

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: PRUNEDA, DORA FAMILY CHILD CARE	FACILITY NUMBER: 153910711
	VISIT DATE: 03/17/2020

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
26
27
28
29
30
31
32

Lead safety was discussed, and LPA provided Ms. Chavez with a brochure. Ms. Chavez was informed that lead safety information must also be provided to parents and/or authorized representatives of children in care. There is proof of Child Abuse Mandated Reporter Training certification, within the FCCH, for Licensee and Ms. Chavez, completed 01/14/20 and 01/31/18 respectively. Ms. Chavez was advised that because this certification must be renewed every two years; she must complete the training again as soon as possible.

According to Ms. Chavez, Incidental Medical Services (IMS) are not currently being provided. Ms. Chavez was advised that if/when any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Ms. Chavez was advised that the Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

Hours of operation are Sunday through Saturday, from 4:00 AM to 11:00 PM, and as arranged; less than 24 hours.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiencies were found: (see LIC809-D)

In exit interview, Ms. Chavez was advised of the licensee’s appeals rights and was provided with Appeals Rights. Ms. Chavez was informed that the she and/or the licensee must post this report with Type A Deficiencies for 30 days where parents may easily view and file in facility file for public review for three years.

Ms. Chavez was advised that she and/or the licensee must make this licensing report accessible to the public and to provide copies of this licensing report and LIC 809-D with Type A citation to parents/legal guardians of children in care and to parents/legal guardians of children newly enrolled at the facility during the next 12 months. Ms. Chavez was advised that the licensee is required to keep the Acknowledgement of Receipt of Licensing Reports (LIC 9224) in each child's file at the facility. An LIC9224 and Assembly Bill 633 facts sheet was provided to Ms. Chavez on this date.

Ms Chavez was advised the that the Notice of Site Visit (LIC9213) provided to her is required to be posted for 30 days.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: PRUNEDA, DORA FAMILY CHILD CARE	FACILITY NUMBER: 153910711
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/17/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/20/2020 Section Cited	1 2 3 4 5 6 7	All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:Obtain a California clearance or a criminal record exemption as required by the Dept. This requirement was not met as evidenced by LPA's
	8 9 10 11 12 13 14	observations, records review,and staff interviews. Today, LPA observed Adult #1 caring for children within the FCCH. In addition, during an interview with Ms. Chavez, and a telephone interview with the licensee, LPA confirmed Adult #2 has been residing in the home for several months. Review of Licensing Information System records, LPA confirmed Adult #1& Adult #2 have not obtained criminal record clearance as required. This poses an immediate risk to the health, safety, or personal rights of children in care. A civil penalty of $1000.00 was assessed.	8 9 10 11 12 13 14	Licensee and Ms. Chavez were advised that until criminal record clearance is obtained for Adult #1 and Adult #2, neither individual are allowed to work or reside at the FCCH.
04/02/2020 Section Cited	1 2 3 4 5 6 7	A small family day care home may provide care for more than six and up to eight children, without an additional adult attendant, if all of the following conditions are met: At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.
	8 9 10 11 12 13 14	This requirement was not met, as evidenced by LPA's observations. Today, LPA observed Ms. Chavez providing care to seven children, ages 1-5. Of the children present, none were school age and/or enrolled and attending kindergarten as required. This poses an immediate risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14	This plan is to be submitted to the Fresno CCL office by 04/02/20.

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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2020

LIC809 (FAS) - (06/04)

Page: 3 of 3