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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203807077
Report Date: 11/26/2019
Date Signed: 11/27/2019 09:45:32 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:GUTIERREZ, LAURA FAMILY CHILD CAREFACILITY NUMBER:
203807077
ADMINISTRATOR:GUTIERREZ, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 675-1678
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 13DATE:
11/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Laura GutierrezTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced Annual/Random inspection and met with Licensee, Laura Gutierrez and 2 assistants. LPA explained the reason of the inspection and a tour of the home was conducted both inside and outside. LPA observed licensee and her 2 assistants caring for 13 children.

Licensee stated that children have access to the whole house which includes the living room, kitchen/dining room area, 1 bedroom, 1 bathroom, and backyard. LPA observed plenty of age appropriate toys, cubbies, books, play pens, and small tables and chairs. LPA also observed that the day-care home was clean and free of toxins during todays inspection. Licensee stores her knifes and medications up high which are inaccessible to children in care. The laundry room is next to the dining room and licensee stores her cleaning supplies and laundry detergent up high which is inaccessible to children in care.
The bathroom was found clean and free of toxins.

LPA spoke about the safe sleep regulations that will take affect this year with the 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 backyard has a fence that goes all around. LPA observed plenty of age appropriate toys, bikes/tricycles, and small plastic play houses. Licensee has a 2A10 BC fire extinguisher that was purchased on September 2019. LPA explained to licensee that she needs to get it serviced or replaced yearly. Licensees CPR/First Aid certificate that's good until 05/25/2021. The last time licensee conducted fire drills with children was on 10/07/2019. The carbon monoxide and smoke detector were tested and found in working condition. LPA reviewed 5 children's files along with the children's roster and everything was completed and up to date.

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: 11/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019
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: GUTIERREZ, LAURA FAMILY CHILD CARE
FACILITY NUMBER: 203807077
VISIT DATE: 11/26/2019
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Licensee stated that there are no guns or ammunition in the home and LPA did not observe any bodies of water during todays inspection. Licensee and her 2 assistants are current with the immunization requirements per SB 792. Mandated Reporter Training AB 1207 was discussed during todays inspection.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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, No deficiencies were observed or cited.



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: 11/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019
LIC809 (FAS) - (06/04)
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