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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203907605
Report Date: 04/19/2023
Date Signed: 04/19/2023 04:02:08 PM


Document Has Been Signed on 04/19/2023 04:02 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:GARCIA, EDILIA FAMILY CHILD CAREFACILITY NUMBER:
203907605
ADMINISTRATOR:GARCIA, EDILIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 673-1665
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 8DATE:
04/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:01 PM
MET WITH:GARCIA, EDILIATIME COMPLETED:
04:15 PM
NARRATIVE
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On 4/19/2023, Licensing Program Analyst (LPA) Stephanie Vega-Gonzalez conducted an unannounced Case Management inspection and other inspection. LPA met with Licensee Edilia Garcia, and introduced themselves, and provided business card, and explained the reason for the inspection. Also present were Assistant 1, Iise Garcia and Assistant 2, Amparor Esqueda. Licensee is Spanish Speaking and LPA assisted with interpretation. Days and hours of operation are Sunday to Friday with overnight care and is closed on Saturdays. LPA reviewed overnight care regulations with licensee.

During today's inspection LPA observed Child 4 sleeping in a baby swing located inside of a play yard. LPA observed Child 3 sleeping in second play yard that had no fitted sheets. LPA observed that second play yard had a tear on the mesh. LPA observed that first play yard had a loose blanket on mattress. LPA discussed safe sleep regulations with Licensee and Assistant 1, Ise Garcia. During inspection LPA reviewed children's file and it was revealed that Child 3, and Child 4 did not have the required documents in facilities which included the 15 minute safe sleep logs or the LIC 9227. Licensee stated that infants are always physically observed by themselves or Assistant 1, yet can not provide documentation. LPA observed during record review that Child 1, Child 2, Child 3, Child 4, Child 5, Child 6, Child 7, and Child 8 did not have the LIC9224 document on file.

LPA provided copies of PIN 20-24-CCP Recently Approved Safe Sleep Regulations in Effect, LIC 9227 Individual Infant Sleeping Plan, and resources. Licensee understands that there shall be one 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 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.

LPA discussed the safe sleep regulations with Licensee Edilia Garcia 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.

SUPERVISOR'S NAME: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/19/2023 04:02 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: GARCIA, EDILIA FAMILY CHILD CARE
FACILITY NUMBER: 203907605

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/26/2023
Section Cited

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1596.8595 Posting licensing report by child care facility or home; duration of posting; civil penalty for failure to comply; reports to be provided to parents or guardian of each child receiving services .Health and Safety Code Section 1596.8595 (c) A licensed child care facility or home shall ....
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Licensee stated that they will have parents complete the LIC9224 document and submit it to CCL on POC due date.
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Type A citation that represents.... Based on record review, the licensee did not comply with the section cited above in that, during record review LPA observed that 8 out of 8 children did not have the LIC9224 in file, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
04/26/2023
Section Cited

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102425 INFANT SAFE SLEEP (a) There shall be . . .(3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.
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Licensee stated that they will purchase a new play yard and purchase fitted sheets for each infant in care, and provide proof to CCL by POC due date.
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The licensee did not comply with the section cited above in that, during record LPA observed that two play yards did not have fitted mattress. LPA had provided a TV on 12/13/2023 regarding same regulation, which poses/posed a potential health, safety or personal rights risk to persons 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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 2 of 5


Document Has Been Signed on 04/19/2023 04:02 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: GARCIA, EDILIA FAMILY CHILD CARE
FACILITY NUMBER: 203907605

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/26/2023
Section Cited

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102425 INFANT SAFE SLEEP
(i) If an infant falls asleep before being placed in a crib or play yard, the provider shall move the infant to a crib or play yard as soon as possible. Based on observation, the licensee did not comply with the section cited above in that,
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Licensee stated that they will review PIN 20-24-CCP Recently Approved Safe Sleep Regulations, and write a statement on what they have learned to CCL on POC due date.
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 LPA observed Child 4 sleeping inside a baby swing placed inside a play yard, which poses an immediate health, safety or personal rights risk to persons 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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5


Document Has Been Signed on 04/19/2023 04:02 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: GARCIA, EDILIA FAMILY CHILD CARE
FACILITY NUMBER: 203907605

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/21/2023
Section Cited

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102425 INFANT SAFE SLEEP
(c) An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 month of age the provider has in care and maintained at the facility in the infant’s file. (2) ...
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Licensee stated that they shall complete the LIC9227 for Child 3 and Child 4 and submit proof of document to CCL by POC due date.
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 The licensee did not comply with the section cited above in that, during record review LPA did not observe LIC9227 for Child 3 and Child 4, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
04/21/2023
Section Cited

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102425 INFANT SAFE SLEEP
(j) The provider shall supervise infants while they are sleeping ... (2)The provider shall check and document the following:
(D)Documentation shall be maintained in the infant’s file ... c.Time of each 15-minute check.
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Licensee stated that they will start the 15 minute logs and submit proof to CCL by POC due date for both Child 3 and Child 4.
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The licensee did not comply with the section cited above in that, during record review of Child 3 and Child 4, LPA noted that both infants did not have documentation of 15 minute checks, which poses/posed a potential health, safety or personal rights risk to persons 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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5


Document Has Been Signed on 04/19/2023 04:02 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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: GARCIA, EDILIA FAMILY CHILD CARE
FACILITY NUMBER: 203907605

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/21/2023
Section Cited

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102421 Child's Records
(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7).
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Licensee stated that they will complete a facility file for Child's Records for both Child 3 and Child 4 and submit it to CCL by POC due date.
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 The licensee did not comply with the section cited above in that, during record review LPA did not observe a facility file for Child's Records for Child 3 and Child 4, which poses/posed a potential health, safety or personal rights risk to persons 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: Juvenal MoctezumaTELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-GonzalezTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5