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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911274
Report Date: 06/24/2021
Date Signed: 06/24/2021 01:59:23 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:HERRERA, ROSA FAMILY CHILD CAREFACILITY NUMBER:
153911274
ADMINISTRATOR:HERRERA, ROSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 619-1073
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY:14CENSUS: 2DATE:
06/24/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Jessica HerreraTIME COMPLETED:
02:30 PM
NARRATIVE
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On 6/24/21 Licensing Program Analyst's (LPAs) Caroline Harris and Roman Iglesias attempted to conduct an unannounced annual inspection, however the licensee was not present. LPA's met with the licensee's niece, Jessica Herrera who was caring for two day care children. However, Jessica Herrera is not fingerprint cleared and associated to the licensee's day care license. The father of the two children picked up the children.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are found (see next page): 809 D

"Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months."

A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 was given to Ms. Herrera to provide to the licensee.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021
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: HERRERA, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 153911274
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
06/24/2021
Section Cited

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Criminal Record Clearance. All individuals subject to a criminal record review as specified in H&S Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption.

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LPA's observed an unfingerprinted person watching two day care children. Ms. Herrera stated that she was helping for today only as there was an emergency. Therefore, a civil penalty is assessed ($100.00 per violation per day for a maximum of five days by the Department).
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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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Caroline HarrisTELEPHONE: (559) 341-4624
LICENSING EVALUATOR SIGNATURE:
DATE: 06/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2021
LIC809 (FAS) - (06/04)
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