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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 163909944
Report Date: 02/19/2020
Date Signed: 02/21/2020 09:38:12 AM

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:MORALES, GRACIELA FAMILY CHILD CAREFACILITY NUMBER:
163909944
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
02/19/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Graciela MoralesTIME COMPLETED:
02:30 PM
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On 2/19/2020, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced annual inspection. LPA met with Licensee, Graciela Morales, who provided a tour of the home, inside and outside, as shown on the facility sketch. There were no "bodies of water" or firearms in this facility. Poisons, cleaning compounds, medications and other hazardous items were inaccessible to children. The fireplace was inaccessible to children. The fire extinguishers, smoke detectors, and carbon monoxide indicator met Community Care Licensing (CCL) regulations. The home was kept clean and orderly, with heating and ventilation for safety and comfort. There were no stairs in the home. Safe toys and play equipment were observed. There was one dog at the home that does not have access to day care children. Licensee had a working telephone and the above telephone number was verified. Adequate supervision was being provided during this inspection. Outdoor play areas were fenced or supervised by the Licensee or care giver. Capacity as specified on the license was being maintained. Children’s records contained all emergency information specified by regulation. There were no excluded individuals present at this home. All adults who reside or work in the home had a criminal record clearance or exemption as indicated on LIS 531 – Facility Personnel Report Summary. The Licensee and other personnel as specified completed training on preventative health practices including pediatric CPR and first aid; Expires: 5/18/21.

Incidental Medical Services (IMS) policy was discussed. Licensee is aware that an IMS plan is required to be submitted to the Licensing office if they provide any of these services.

LPA provided Licensee with information regarding the California Department of Social Services (CDSS) Provider Information Notices (PINs) communication system; information regarding Safe Sleep Regulations; AB 2370, Chapter 676, Statutes of 2018, requiring child care providers to inform parents and/or guardians with lead safety information, and other important resources and information links offered on the CDSS website.
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SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
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: MORALES, GRACIELA FAMILY CHILD CARE
FACILITY NUMBER: 163909944
VISIT DATE: 02/19/2020
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Business hours are Monday through Friday 3:00 AM to 11:00 PM and other hours as arranged.

Per Title 22 of the California Code of Regulations no deficiencies were observed today.

Exit interview conducted with Licensee. A copy of the report and the Notice of Site Visit form (LIC 9213) provided to Licensee.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020
LIC809 (FAS) - (06/04)
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