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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203902366
Report Date: 06/14/2019
Date Signed: 06/14/2019 04:20:21 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:MUNOZ, CLAUDIA FAMILY CHILD CAREFACILITY NUMBER:
203902366
ADMINISTRATOR:MUNOZ, CLAUDIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 481-0434
CITY:MADERASTATE: CAZIP CODE:
93637
CAPACITY:14CENSUS: 11DATE:
06/14/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Claudia MunozTIME COMPLETED:
04:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Angelica Slaughter conducted an unannounced Annual/Random inspection. LPA met with Licensee Claudia Munoz. Licensee is primarily Spanish speaking. Upon LPAs arrival, LPA counted 11 children in care. Licensee's daughter/assistant Nataly Ramirez was not at the home, therefore putting the Licensee over capacity/out of ratio. Within 5 minutes of LPA's arrival, four of the children were picked up by their parent. Licensee called her assistant to come home because licensing was at the home. Assistant arrived within 10 minutes of LPA's initial arrival time. LPA conducted a tour of the home as shown on the facility sketches (LIC 999A) provided. Accessible areas of the home are the formal dining room, kitchen area, living room, dining room, hallway bathroom and family daycare room. Back yard is currently not being used. Per Licensee all other rooms are to be inaccessible. However, at the time of this inspection, bedrooms were unlocked. They did not have spinning door knob covers to make them inaccessible. Safe toys and safe indoor play areas were observed. LPA observed one small dog inside the home during today's inspection. Licensee understands she is responsible for the children's safety around pets at all times. There are no firearms in the home. No poisons were observed on the premises. Licensee was reminded that cleaning compounds, medications and other hazardous items are to be inaccessible to children. There is a fireplace. Licensee stated it is not used during daycare hours. There are no stairs in the home. There is a working fire extinguisher, smoke detector and adequate heating and ventilation for safety and comfort. There is no carbon monoxide indicator. There is a working telephone (559) 481-0434 and number was verified. Adequate supervision is being provided during this inspection. Capacity as specified on the license is being maintained. Licensee was reminded to maintain a current roster of the children. Licensee could not provide documentation of immunization for pertussis, measles and influenza for herself. A fire drill log was not available on this inspection. Licensee is aware that children are never to be left in parked vehicles. 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. Licensee signed LIS 531 confirming finger print cleared adults associated to the day care. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Licensee’s Pediatric CPR/First Aid expires 09/18/20. Licensee's assistant was advised to complete AB 1207 Mandated Reporter Training immediately. (Continued on 809-C)
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019
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 5
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: MUNOZ, CLAUDIA FAMILY CHILD CARE
FACILITY NUMBER: 203902366
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/14/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/28/2019
Section Cited
HSC
1597.543
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Carbon monoxide detectors required; inspection- Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the
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Licensee states that she will purchase a carbon monoxide detector and submit a copy of purchase receipt/photo of installed carbon monoxide detector to CCL by 06/28/2019.
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presence of these detectors during inspection. This requirement was not met as evidenced by Licensee failing to have a carbon monoxide detector in her home. This poses a potential health and safety risk to children in care.
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Type B
06/28/2019
Section Cited
CCR
102417(g)(9)(A)(1)
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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:
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Licensee stated that she will conduct fire drill and submit a copy to CCL by 06/28/2019.
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Licensee failing to produce a fire & Disaster drill log sheet. This poses a potential health and 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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: MUNOZ, CLAUDIA FAMILY CHILD CARE
FACILITY NUMBER: 203902366
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/14/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/17/2019
Section Cited
CCR
102416.5(a)
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Staffing Ratio and Capacity. The capacity specified on the license shall be the maximum number of children for whom care can be provided. This requirement is not met as evidenced by today's inspection. Upon LPAs arrival, LPA observed a totoal of 11 children in care. Licensee was operating daycare without
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Within 5 minutes of LPA commencing inspection, a parent arrived and picked up four of the children putting the licensee back into compliance. Licensee stated this situation would not occur again. Written statement to be submitted to CCL by 6/17/19.
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an assistant at the time of this inspection. This posses an immediate risk to the health, safety and personal rights of 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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: MUNOZ, CLAUDIA FAMILY CHILD CARE
FACILITY NUMBER: 203902366
VISIT DATE: 06/14/2019
NARRATIVE
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Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. Licensee confirmed that there are no Registered Sex Offenders living in the home and/or using the facility address for their mailing address. Days and hours of operation are Monday through Friday; 4:00 AM – 10:30 PM and as arranged.

Incidental Medical Services (IMS) policy was discussed. 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

LPA provided Licensee with information regarding the California Department of Social Services (CDSS) Provider Information Notices (PINs) communication system; 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. LPA also discussed safe sleep with Licensee.



Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found: (see LIC809-D) Exit interview was conducted with licensee.

"Upon receipt, 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 LIC 9224 was given to licensee.



Licensee was provided a copy of this report, as well as form LIC 9213. Licensee was provided a copy of appeal rights.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: MUNOZ, CLAUDIA FAMILY CHILD CARE
FACILITY NUMBER: 203902366
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/14/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/28/2019
Section Cited
CCR
102417(g)(8)
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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 today's inspection. LPA conducted file review of the children's roster. Upon interview with licensee, she stated that she does not have a children's roster.
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Licensee stated that she will complete a children's roster and submit a copy to CCL by 06/28/19.
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This poses a potential health and safety risk to children in care.
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Type B
06/28/2019
Section Cited
CCR
102421(b)
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Child's Records. The licensee shall maintain, in each child's record, a copy of the emergency information card required in Section 102417(g)(7). This requirement is not met as evidenced by observation and records review conducted during today’s inspection. Licensee stated she did not have any paperwork for
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Licensee stated she will locate all children's file documents and have ready for LPAs follow up inspection or will submit to CCL by 6/28/19.
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children. Stated she was in process of reorganizing and documents were in a box in the garage. This poses as a potential risk to the health, safety, or personal rights of 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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5