163903188-11-25-2019-04-CC-RGUZ-BJ9SL8-20191125125754

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 163903188
Report Date: 11/25/2019
Date Signed: 11/25/2019 12:58:18 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:	PULIDO, ALEJANDRA FAMILY CHILD CARE		FACILITY NUMBER:	163903188
ADMINISTRATOR:	PULIDO, ALEJANDRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 386-2965
CITY:	AVENAL	STATE: CA	ZIP CODE:	93204
CAPACITY:	14	CENSUS: 1	DATE:	11/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Alejandra Pulido		TIME COMPLETED:	01:15 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	Licensing Program Analyst (LPA), Robert Gutierrez, conducted an unannounced annual inspection and was met by Licensee, Alejandra Pulido. Licensee is Spanish Speaking. LPA toured the home inside and outside and a census was taken. The child present was the licensee’s minor child. Current facility sketch reviewed and Licensee confirmed that the living room, bedroom #1, dining room, kitchen, playroom and back yard are accessible to children. All other rooms are off-limits and made inaccessible by use of plastic spinners and door locks. There are no swimming pools or other bodies of water on the premises. The outdoor play area in the backyard is fenced and there are no hazards to children present. There are no firearms or ammunition on the premises. Safe toys and play equipment are observed. Cleaning compounds such as pledge, bleach and mold remover were observed in a cabinet underneath the kitchen sink. LPA observed several knives in a kitchen drawer. Both the cabinet and drawer did not contain a preventative entry device to make these items inaccessible to children. Licensee removed these items and placed them all in the inaccessible garage. No poisons were observed during inspection. There are no stairs in this home. There is no fireplace in the home. There is working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Licensee has one dog inaccessible to children. Licensee understands the liability and safety of children around pets and accepts responsibility. The dog is kept in a kennel located in the backyard. Capacity as specified on the license is being maintained. Licensee’s pediatric CPR/First Aid expires on 03/2020. Licensee has a working telephone and the above telephone number was verified. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and notification of parents rights poster are posted on the dining room wall. Days and hours of operation are Monday - Saturday, 4:00 am to 5:00 pm. Continued on 809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2019

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: PULIDO, ALEJANDRA FAMILY CHILD CARE	FACILITY NUMBER: 163903188
	VISIT DATE: 11/25/2019

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Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide these services. The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link
https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Inspection is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2019

LIC809 (FAS) - (06/04)

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