153910711-12-5-2022-57-CC-JTHN-CLTUD4-20221205142856

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153910711
Report Date: 12/05/2022
Date Signed: 12/05/2022 02:29:01 PM

Document Has Been Signed on 12/05/2022 02:29 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 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: 2	DATE:	12/05/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Dora Pruneda		TIME COMPLETED:	02:45 PM

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On 12/05/2022, Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced Annual Required Inspection and was met by Licensee Dora Pruneda. Days and hours of operation are Monday – Friday, from 4:00 AM to 6:00 PM.

LPA toured the home inside and outside, and a census was taken. Current facility sketch was reviewed, and Licensee confirmed that the living room, kitchen, dining room, and hallway bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of baby gates.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are inaccessible. The fireplace in the living room is made inaccessible by shelving and will not be used during day-care hours. 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. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (661) 910-4394.

Licensee does not have any infants enrolled at this time. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information -and-resources /safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 and there are no hazards to children present (see next page, LIC809).

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2022

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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: PRUNEDA, DORA FAMILY CHILD CARE	FACILITY NUMBER: 153910711
	VISIT DATE: 12/05/2022

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Capacity as specified on the license is being maintained. LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter training was completed on 1/18/22. Licensee’s pediatric CPR/First Aid expires 2/19/2024. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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: 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, no deficiencies were cited. Licensee was provided a copy of their appeal rights.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Dora Pruneda.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: (559) 341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2022

LIC809 (FAS) - (06/04)

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