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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203809838
Report Date: 11/26/2019
Date Signed: 11/26/2019 01:11:34 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:BELTRAN, CARMEN FAMILY CHILD CAREFACILITY NUMBER:
203809838
ADMINISTRATOR:BELTRAN, CARMENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 673-8351
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 3DATE:
11/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Carmen BeltranTIME COMPLETED:
01:25 PM
NARRATIVE
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Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced Annual/Random inspection and met with Licensee, Carmen Beltran and husband. LPA explained the reason of the inspection and a tour of the home was conducted both inside and outside. LPA observed licensee caring for 3 child whom were all in the playroom watching TV.

Licensee stated that children have access to the playroom, living room, kitchen/dining room area, family room, 1 bathroom, and backyard. Licensee stated that all bedrooms are inaccessible to children and are closed and locked during day-care hours. LPA observed plenty of age appropriate toys, 3 playpens, cubbies, and small tables and chairs. LPA also observed that the day-care home was clean and free of toxins. The knives are stored up high in a kitchen cabinet which are inaccessible to children in care. The cleaning supplies/toxins are stored inside garage which is off limits. 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 bathroom was found clean and free of toxins during the inspection. The backyard has a fence that goes all around. LPA observed plenty of age appropriate toys and a wooden play structure.

Licensee has a 2A10 BC fire extinguisher that was last serviced in February 05, 2009. LPA explained to licensee that she needs to get it serviced or replaced yearly. Both the licensee and her husbands CPR/First Aid certificate is good until 02/25/2021. The licensee does not have proof that she has conducted the fire drills within 6 months. The carbon monoxide and smoke detector were tested and found in working condition. A Child's file was reviewed along with the children's roster and everything was completed and up to date. 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 does not have proof that she is current with the immunization requirements per SB 792. Mandated Reporter Training AB 1207 was also discussed during todays inspection.
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)
Page: 1 of 3
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: BELTRAN, CARMEN FAMILY CHILD CARE
FACILITY NUMBER: 203809838
VISIT DATE: 11/26/2019
NARRATIVE
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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 B deficiencies were observed and cited. Appeal rights were explained and provided to Carmen Beltran.



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.


This report was translated in Spanish by LPA Moctezuma.

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)
Page: 2 of 3
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: BELTRAN, CARMEN FAMILY CHILD CARE
FACILITY NUMBER: 203809838
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/13/2019
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 both her and her husband 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
12/06/2019
Section Cited

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Operation of a Family Child Care Home. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. This requirement was not met as evidenced by interview.
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Licensee informed LPA that she has not completed an actual fire drill and has not documented required fire drills with the date and time. This poses a potential health, safety, or personal rights risk to the children in care.
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Licensee will send a copy of the above mentioned fire drill documentation to LPA by 12/13/19.
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: 11/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/26/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3