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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203904288
Report Date: 02/05/2020
Date Signed: 02/05/2020 01:37:55 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:RIVERA, CELESTE FAMILY CHILD CAREFACILITY NUMBER:
203904288
ADMINISTRATOR:RIVERA, CELESTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 673-0830
CITY:MADERASTATE: CAZIP CODE:
93637
CAPACITY:14CENSUS: 10DATE:
02/05/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Celeste RiveraTIME COMPLETED:
01:50 PM
NARRATIVE
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Licensing Program Analyst (LPA) Angelica Slaughter conducted an unannounced Annual/Random inspection. LPA met with Licensee Celeste Rivera. Also present during this inspection was Licensee's Assistant Sylvia Chavez and two minor relatives. This facility is licensed as a large facility of 14, there must be an additional qualified staff person present anytime the facility goes beyond the ratio for a capacity of eight. LPA conducted a tour of the home as shown on the facility sketches (LIC 999A) provided. Accessible areas of the home are the living room, dining room, kitchen, daycare room, a bedroom, hall bathroom and back yard. The Master Bedroom is being made off-limits as of today's inspection. All other rooms in the home are made inaccessible by sliding locks at the top of the door or by locked doors. There are a total of four dogs present during today's inspection. Three of the dogs were inaccessible to the children and behind a fenced area of the yard. Licensee understands she is responsible for the safety of children around pets. There is an above ground pool in the back corner of the yard that is fenced per regulation requirements. There are no firearms in the home. No poisons were observed on the premises. There is no fireplace or stairs in the home. There is a working fire extinguisher, smoke detector, carbon monoxide indicator and adequate heating and ventilation for safety and comfort. There is a working telephone (559) 706-4759 and number was verified. Adequate supervision is being provided during this inspection. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee maintains documentation of immunization for pertussis, measles and influenza for herself and her assistant. Fire drills are conducted every six months. 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. Licensee verified clearances by signing LIS 531. There are no excluded individuals present at this home. 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 07/25/21. Licensee completed Mandated Reporter Training on 04/12/18. 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 facility and/or using the facility address for their mailing address.

Continued on 809-C

SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Angelica SlaughterTELEPHONE: (559) 341-3920
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020
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: RIVERA, CELESTE FAMILY CHILD CARE
FACILITY NUMBER: 203904288
VISIT DATE: 02/05/2020
NARRATIVE
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Days and hours of operation are Monday – Friday; 6:30 AM – 5:30 PM and as arranged.

Incidental Medical Services (IMS) policy was discussed.

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 Title 22, Division 12, Chapter 3, of the California Code of Regulations, there were deficiencies found on today's inspection. (See 809 D)

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

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: 02/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020
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: RIVERA, CELESTE FAMILY CHILD CARE
FACILITY NUMBER: 203904288
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/07/2020
Section Cited

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Operation of a Family Child Care Home; The home shall be free from defects or conditions which might endanger a child. This requirement was not met as evidenced by: Based on observation, Licensee failed to maintain the backyard free of defects including several piles of dog feces on the lawn and two ice chests
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filled with glass beer bottles were accessible to children in care. Children were being supervised outside during this inspection. This posses a potential risk to the health, safety and/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: 02/05/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3