<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203809838
Report Date: 12/12/2022
Date Signed: 12/12/2022 02:33:53 PM


Document Has Been Signed on 12/12/2022 02:33 PM - It Cannot Be Edited

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) 479-8607
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 8DATE:
12/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Carmen BeltranTIME COMPLETED:
02:45 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
On 12/12/2022 Licensing Program Analyst (LPA), Stephanie Vega-Gonzalez, conducted an unannounced Annual Required Inspection and was met by Licensee, Carmen Beltran. LPA explained the reason for the visit. Also present was Licensee’s Assistant, Guadalupe Beltran. Licensee is Spanish Speaking and LPA assisted with interpretation during inspection. Days and hours of operation are Monday through Saturday from 3:00am to 5:30pm

LPA toured the home inside and outside and a census was taken of 8. Current facility sketch reviewed, and Licensee confirmed that the playroom, living room, kitchen/dining room area, family room, hallway bathroom, and backyard are accessible and used for children in care. All other rooms are off-limits and made inaccessible by use of locks on doors. LPA did not observe a swimming pool on the premises. LPA observed a yellow mop bucket and wringer with wheels filled with water in backyard. LPA observed a small 1-gallon white bucket filled with water. LPA observed Licensee dump out containers during inspection. There are no firearms or ammunition on the premises.

LPA observed all poisons are kept in a locked storage area in backyard shed. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

The fireplace located in the family room is made inaccessible by a wooden panel. Licensee stated that fireplace will not be in use during daycare hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. LPA observed licensee test the smoke detector and carbon monoxide. Licensee understands to test both smoke detector and carbon monoxide periodically for functionality. LPA did not observe any stairs in this home. The home has working telephone service and LPA confirmed the phone number is (559) 479-8607.

(Continue on LIC809-C)

SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2022
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


Document Has Been Signed on 12/12/2022 02:33 PM - It Cannot Be Edited

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: 12/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(5)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that, LPA observed a yellow mop bucket and wringer with wheels filled with water in backyard. LPA observed a small 1-gallon white bucket filled with water. LPA observed Licensee dump out containers during inspection, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/13/2022
Plan of Correction
1
2
3
4
Licensee dumped out containers during inspection. Licensee has stated they will watch video on "Bodies of Water Requirements in Child Care" and write a statement on what they have learned to CCL by POC due date. Website for video: www.ccld.childcarevideos.org
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2022
LIC809 (FAS) - (06/04)
Page: 2 of 6


Document Has Been Signed on 12/12/2022 02:33 PM - It Cannot Be Edited

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: 12/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(d)
Operation of A Family Child Care Home
(d) The home shall provide safe toys, play equipment and materials.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that, LPA observed a broken swing and a broken wooden stair climber on backyard's playground equipment, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/12/2022
Plan of Correction
1
2
3
4
Licensee removed broken wooden climber and swing from playground set on today's inspection.
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in that, LPA observed a Vavlvoline Full Synthetic 10W-30 half filled bottle 4.73 L next to the trash cans on side walkway in backyard. Bottle had safety feature on bottle cap.

which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/26/2022
Plan of Correction
1
2
3
4
Licensee removed Vavlvoline bottle and placed it in locked shed in backyard. Licensee stated that they will watch video titled: "Locks and Inaccessibility Requirements in Child Care" and write a statement on what they have learned. Website is www.ccld.childcarevideos.org
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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6


Document Has Been Signed on 12/12/2022 02:33 PM - It Cannot Be Edited

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: 12/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in that, Licensee was unable to provide current copies of Mandated Reporter for herself and Assistant, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/26/2022
Plan of Correction
1
2
3
4
Licensee and Assistant will complete Mandated Reporter Training and submit a copy to CCL by due date. Training can be taken online in English or Spanish at www.mandatedreporterca.com
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in that, Licensee did not have an updated children's roster, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/26/2022
Plan of Correction
1
2
3
4
Licensee stated that they will provide CCL with a current copy of a Children's Roster and will keep original in file at facility, and update it when needed.
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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2022
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: BELTRAN, CARMEN FAMILY CHILD CARE
FACILITY NUMBER: 203809838
VISIT DATE: 12/12/2022
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
26
27
28
29
30
31
32
LPA did not observe any infants in care during inspection. Licensee sated that they are not currently caring for any infants. LPA discussed Safe Sleep Regulations with licensee. LPA observed two play yards in family living room. Licensee understands the following: there should be a crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. License understands that infants are not swaddled while in care. Licensee understands to complete physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

Licensee does not have a current roster of the children. An emergency fire/disaster drill had been completed on 9/12/22 and was documented within the last 6 months. Licensee and Assistant do not have a current Mandated Reporter Training. Licensee’s pediatric CPR/First Aid expires on 2/18/2023. Assistants pediatric CPR/First Aide expires on 2/18/2023. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

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.

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 any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.



(Continue on LIC809-C)
SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022
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: BELTRAN, CARMEN FAMILY CHILD CARE
FACILITY NUMBER: 203809838
VISIT DATE: 12/12/2022
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
26
27
28
29
30
31
32
Licensee Carmen Beltran was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

LPA discussed the safe sleep regulations with Licensee Carmen Beltran and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov and recommended they register all infants devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process



Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

Upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 was given to licensee.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative Carmen Beltran

SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2022
LIC809 (FAS) - (06/04)
Page: 6 of 6