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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203902432
Report Date: 09/05/2019
Date Signed: 09/05/2019 11:55:29 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:MUNOZ, YOLANDA FAMILY CHILD CAREFACILITY NUMBER:
203902432
ADMINISTRATOR:MUNOZ, YOLANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 661-2180
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 14DATE:
09/05/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Yolanda MunozTIME COMPLETED:
12:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced Plan Of Correction (POC) inspection and met with Licensee, Yolanda Munoz and her assistant. LPA explained the reason of the inspection and a tour of the home was conducted both inside and outside. LPA observed licensee and her assistant caring for 14 children.

LPA asked licensee to write down the names and ages of the children she was caring for so there wouldn't be any confusion with the names or ages of the children she was currently caring for. Based on LPAs observation and licensee writing down the names and ages of the children in care, LPA noticed that licensee was caring for a total of 4 infants and none of the children were enrolled in school or over the age of 6. Licensee stated that she thought that she didn't need to have anyone currently enrolled in school or be over the age of 6 to care for 14 children at once. Licensee started calling parents to pick up 2 children so she would be left with only caring 12 children.

Licensee provided LPA with a copy of her completed Children's Roster. LPA observed that the home was clean and free of toxins. Licensee removed all the cluttered items from her dining room and kitchen area. The floors were observed to be clean. The bedrooms were closed and locked during todays inspection. The bathroom was found clean and free of toxins. After concluding the inspection, Licensee was left with 12 children.

This facility plans to provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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: 09/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019
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: MUNOZ, YOLANDA FAMILY CHILD CARE
FACILITY NUMBER: 203902432
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/05/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/06/2019
Section Cited

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A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met: (a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.
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This requirement was not met as evidenced by licensee caring for 14 children and not having at least one child enrolled or attending kindergarten or elementary school and a second child being at least 6 years old. This poses an immediate health/safety risk to children in care
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Type A
09/06/2019
Section Cited

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A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met: (b) No more than three infants are cared for during any time when more than 12 children are being cared for.
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This requirement was not met as evidenced by Licensee caring for 14 children and 4 of them being under the age of 2 years old. This poses an immediate health and 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: 09/05/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/05/2019
LIC809 (FAS) - (06/04)
Page: 3 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: MUNOZ, YOLANDA FAMILY CHILD CARE
FACILITY NUMBER: 203902432
VISIT DATE: 09/05/2019
NARRATIVE
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During todays inspection, The following type A Deficiencies were observed. Appeal rights were explained and provided to licensee.

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: 09/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3