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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203804609
Report Date: 10/25/2019
Date Signed: 10/25/2019 03:39:31 PM

COMPREHENSIVE INSPECTION
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:COSIO FAMILY CHILD CAREFACILITY NUMBER:
203804609
ADMINISTRATOR:COSIO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 673-1453
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 8DATE:
10/25/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Maria CosioTIME COMPLETED:
03:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced Annual/Random inspection and met with Licensee, Maria Cosio and assistants. LPA explained the reason of the inspection and a tour of the home was conducted both inside and outside. Licensee stated that she was currently caring for a total of 7 day-care children including her grandchild. LPA observed that licensee was outside with her mom caring for 4 children while 3 children were inside the house with licensees /assistant.

During the inspection, licensees adult daughter left the home with her child, leaving the licensee with 6 day-care children. Licensee stated that children have access to the kitchen area, living/dining room, the playroom, one bathroom, and part of her front yard. Licensee stated that children don't have access to the rooms. LPA reminded licensee that she needs to keep the bedrooms, closets, and another room rooms closed and locked during day-care hours if she wishes to keep them inaccessible to children. Licensee understood.

LPA observed plenty of age appropriate toys in the playroom and observed that the home was cluttered with paperwork and boxes. Licensee stated that she had just finished painting the inside of her home and was putting everything away and getting rid of some items. LPA explained to licensee that she needs to call licensing every time she remodels or makes any changes to her day-care home. Licensee understood.

The bathroom was observed to be clean and free of toxins. LPA observed a knife and other sharp utensils in a bottom drawer along with stainless steel sink cleaners, vitamins, and other cleaning solutions. LPA reminded licensee that such items should be made inaccessible to children in care. Licensee understood and removed the items and placed them up high.

Licensee stated that children only play in the front yard and don't have access to the backyard. Licensee has 10 dogs but only 2 have contact with children. Licensee understands responsibility of any action taken by pets involving day care children. LPA observed plenty of age appropriate toys, a wooden play structure, grass, and shade area in the front yard.
Report continued onto LIC 809-C
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019
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 6
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: COSIO FAMILY CHILD CARE
FACILITY NUMBER: 203804609
VISIT DATE: 10/25/2019
NARRATIVE
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Licensee has a 2A10 BC fire extinguisher that was last serviced on 01/14/2009. LPA explained to licensee that she needs to get it serviced or replaced yearly. Licensees CPR/First Aid certificate is good until 03/09/2021. LPA spoke about the safe sleep regulations that will take affect this year (2019) with licensee and reminded her to not store anything inside the cribs and playpens. LPA also provided licensee with a safe sleep brochure and the new lead brochure.

The carbon monoxide and smoke detector were tested and found in working condition. Through file review it was observed that 3 of the 6 Children's Files were missing. Licensee stated that she will obtain their packets which include the LIC 700, immunization's, emergency consent form, etc. Licensee's children's roster was incomplete and was missing 6 of the children that were present during todays inspection. Licensee stated that there are no guns or ammunition in the home and LPAs did not observe any bodies of water during todays inspection. Licensee has proof that she is up to date with the immunization requirements per SB 792. Licensee did not have proof that her 3 assistants are up to date with the immunization requirements. Mandated Reporter Training AB 1207 was discussed during todays inspection. After concluding the inspection, Licensee was left with 8 children.

During todays inspection, LPA inspected licensees garage where a room was found inside. Inside the room, LPA observed a bed with clothes and asked the licensee if anyone slept there. Licensee stated that her son- Andres Cosio sometimes sleeps over and stays in that room. Licensee stated that her son slept over last night. LPA explained to licensee that her son does not have a fingerprint clearance. An immediate civil penalty is assessed of $100.00 for failure to obtain a criminal record clearance for Licensee's adult son who resides in the home.

Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. 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: http://www.ada.gov/childqanda.htm

During todays inspection, The following type A and Type B Deficiencies were observed. Appeal rights were explained and provided to licensee.

SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: COSIO FAMILY CHILD CARE
FACILITY NUMBER: 203804609
VISIT DATE: 10/25/2019
NARRATIVE
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Upon receipt of this report, licensee shall post for 30 days and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.

This report was translated in Spanish by LPA Moctezuma.

Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

LPA observed licensee post the Notice of Site visit.
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: COSIO FAMILY CHILD CARE
FACILITY NUMBER: 203804609
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/28/2019
Section Cited

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Criminal Record Clearance- All individuals subject to a criminal record review as specified in Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption as required by the Department.
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This requirement was not met as evidenced by Licensee failing to get her adult son, Andre Cosio livescanned before residing in her home. This poses an immediate health/safety risk to children in care.
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Type A
10/28/2019
Section Cited

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Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger to children shall be stored where they are inaccessible to children. This requirement was not met as evidenced by Licensee failing to
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leave her knives, sharp utensils, vitamins, and cleaning solution on the kitchen counter that's accessible to children in care. This poses an immediate health/safety risk to children in care.
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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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2019
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: COSIO FAMILY CHILD CARE
FACILITY NUMBER: 203804609
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/15/2019
Section Cited

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Employees or volunteers at family day care home; immunization requirements; records; exemptions- Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between...
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This requirement was not met as evidenced by interviewing Licensee/file review and licensee not having proof that her 3 assistants are up to date with the immunization requirements per SB 792. This poses a potential health/safety risk to children in care.
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Type B
11/15/2019
Section Cited

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Fireplaces and open-face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal. This requirement was not met as evidenced by licensee having a fire extinguisher that was last
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serviced in 01/14/2009. The fire extinguisher has not been used, serviced or replaced since then. This poses a potential health/safety risk to the children in care.
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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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: COSIO FAMILY CHILD CARE
FACILITY NUMBER: 203804609
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/15/2019
Section Cited

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Operation of a Family Child Care Home. All homes shall have a current roster of the children. This requirement was not met as evidenced by: LPA doing file review of the children's roster and interview with licensee that she does not have a current children's roster.
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All 6 children present during todays inspection were not listed on the children's roster. This poses a potential health and safety risk to children in care.
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Type B
11/15/2019
Section Cited

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Child's Records. The licensee shall maintain, in each child’s record, the signed and dated notice form LIC 995A, Parents Rights Notice and a copy of the emergency information card required in Section 102417(g) (7). This requirement was not met as evidenced by licensee’s interview and missing file/records of 3 of the 6 children present today. Licensee
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failed to meet the regulation for children’s records. Licensee states that she will provide the Licensing forms to the parents and create the children's files. This possess a Potential Health, Safety or Personal Rights Risk to children in care.
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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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2019
LIC809 (FAS) - (06/04)
Page: 6 of 6