203908603-5-9-2019-04-CC-JMOA-BBZTSP-20190509145928

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 203908603
Report Date: 05/09/2019
Date Signed: 05/09/2019 02:59:36 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:	VARGAS, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	203908603
ADMINISTRATOR:	VARGAS, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 481-5134
CITY:	MADERA	STATE: CA	ZIP CODE:	93638
CAPACITY:	14	CENSUS: 7	DATE:	05/09/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:25 PM
MET WITH:	Maria Vargas		TIME COMPLETED:	03:15 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	Licensing Program Analyst (LPA) Juvenal Moctezuma conducted an unannounced Annual/Random inspection and met with Licensee, Maria Vargas. LPA explained the reason of the inspection and a tour of the home was conducted both inside and outside. Licensee arrived approximately 7 minutes later and stated that she was out picking up children from school. LPA observed licensee caring for 4 children and 3 additional children were dropped off 15 minutes later. Licensee stated that children have access to the living room, kitchen area, dining room area, play room (Garage), one bathroom, and backyard. LPA observed plenty of age appropriate toys in the play room. Licensee has also placed plastic door knobs on all her bedrooms and stated that hey are closed and locked during day-care hours. The knives are stored in a high cabinet that's inaccessible to children in care. The cleaning products and toxins are stored in her laundry room which is inaccessible to children in care. The bathroom was found clean and free of toxins during the inspection. The backyard has a fence that goes all around. Licensee has a gate around the pool that meets CCL requirements. LPA Observed plenty of age appropriate toys. Licensee has a wooden play structure, sand box, and play house for children to use. Licensee has just finished remodeling her home. LPA reminded licensee to make sure all the equipment is put away before children play outside. licensee understood. LPA spoke about the safe sleep regulations that will take affect this year (2019) with Maria Vargas and reminded her to not store anything inside the cribs and playpens. LPA also provided licensee with a safe sleep brochure and the new lead brochure. Licensee has a 2A10 BC fire extinguisher that was purchased in February 2019. LPA explained to licensee that she needs to get it serviced or replaced yearly. Maria CPR/First Aid certificate expired on 01/12/2021. Report continued onto LIC 809-C

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019

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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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: VARGAS, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 203908603
	VISIT DATE: 05/09/2019

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The last time Licensee conducted the fire/emergency drills with children was on 01/20/2018. The carbon monoxide and smoke detector were tested and found in working condition. 4 children's files were reviewed along with the children's roster and everything was completed and up to date. Licensee stated that there are no guns or ammunition in the home. Licensee does not have proof that she is current with the immunization requirements per SB 792. Licensee has taken the Mandated Reporter Training AB 1207 on 02/16/2018

Licensee is not providing Incidental Medical Services. 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

During todays inspection, The following type B Deficiencies was observed. Appeal rights provided to Maria Vargas.

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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019

LIC809 (FAS) - (06/04)

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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: VARGAS, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 203908603
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/09/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/31/2019 Section Cited HSC 1597.622(a)(1)	1 2 3 4 5 6 7	Employees or volunteers at family day care home; immunization requirements; records; exemptions- Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between...	1 2 3 4 5 6 7	Licensee sated that she will submit proof of her immunization records to CCL by no later than 05/31/2019.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by interviewing Licensee/file review and licensee not having proof that she is up to date with the immunization requirements per SB 792. This poses a potential health/safety risk to children in care	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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 deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2019

LIC809 (FAS) - (06/04)

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