203909417-3-21-2023-04-CC-DJIZ-CQ627R-20230321170906

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 203909417
Report Date: 03/21/2023
Date Signed: 03/21/2023 05:09:58 PM

Document Has Been Signed on 03/21/2023 05:09 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:	GUERRA, SUSIE FAMILY CHILD CARE		FACILITY NUMBER:	203909417
ADMINISTRATOR:	GUERRA, SUSIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 871-8494
CITY:	MADERA	STATE: CA	ZIP CODE:	93637
CAPACITY:	14	CENSUS: 8	DATE:	03/21/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Susie Guerra		TIME COMPLETED:	12:30 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	On 03/21/2023 Licensing Program Analyst (LPA) Denisia Jimenez conducted an unannounced required one year inspection visit and met with Licensee, Susie Guerra (English Speaking). A tour of the home was conducted, and a census was taken. Current facility sketch reviewed, and Licensee confirmed the first living room, dining room, second living room, kitchen, and hall bathroom are used for providing care and are accessible to day care children. All other rooms are off-limits and are made inaccessible by use of spinner knobs. Hours of operation are Monday through Friday 5:00 AM to 10:30 PM and other hours as arranged. Licensee stated medications are stored in an inaccessible bedroom. LPA observed other hazardous items were inaccessible to children. LPA did not observe any poisons in the home. LPA observed the fireplace located in the second living room was made inaccessible to children by a gate and will not be used during day care hours. The fire extinguishers, smoke detectors, and carbon monoxide detector met Community Care Licensing (CCL) regulations. Heating/cooling and ventilation was sufficient for safety and comfort. Safe toys and play equipment were observed by LPA. Licensee has a working cell phone and the cell phone number was verified. Adequate supervision was being provided during this inspection. Capacity as specified on the license was being maintained. (Large FCCH) Staff-child ratios were maintained. There is currently one infant enrolled. LPA reviewed children's file and the infant sleeping log was missing from one of the children's file. LPA discussed the safe sleep regulations with licensee 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 infant devices with the CPSC to be notified of any recalls on their purchased equipment. (Continued on LIC809-C):

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia Jimenez	TELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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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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: GUERRA, SUSIE FAMILY CHILD CARE	FACILITY NUMBER: 203909417
	VISIT DATE: 03/21/2023

NARRATIVE

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The outdoor play area in the backyard is fenced. Currently, the back yard is not being used due to cold weather temperatures, wind, and rain. LPA had a discussion with Licensee regarding inaccessible items to children be kept inaccessible and picking up dog feces before letting children out to play in the backyard. Licensee stated she will have these items secured and dog feces picked up prior to using the backyard again. LPA made considerations due to rainy weather and children not currently using the backyard today. Licensee ensures that children in care are supervised at all times. Licensee is aware children shall not be left in parked vehicles and is aware car seats are used for transportation purposes only and are not used for sleeping children. Licensee has two dogs and are not accessible to children. Licensee is aware of child safety around pets and accepts responsibility for any action taken by pets. LPA observed there isn’t a swimming pool and Licensee stated there are no firearms on the premises.

A sample of children’s records contained all emergency information specified by regulation. A review of records indicated Licensee and all employees and/or volunteers have proof of required immunization (Pertussis/Measles/Influenza) and/or written declaration declining flu shot. Licensee's Mandated Reporter Training was completed on 02/12/2023. Licensee was reminded the Mandated Reporter Training shall be renewed every two years following the date on which it was initially completed. Licensee's pediatric CPR and First Aid expires on 02/05/2025.

Family Child Care Home is currently NOT providing IMS. 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

(Continued on LIC809-C):

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia Jimenez	TELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GUERRA, SUSIE FAMILY CHILD CARE	FACILITY NUMBER: 203909417
	VISIT DATE: 03/21/2023

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms, and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

An exit interview was conducted, and report was reviewed with the licensee Susie Guerra. A copy of the evaluation report, Appeal Rights and the Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Denisia Jimenez	TELEPHONE: (559) 767-0718
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC809 (FAS) - (06/04)

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