203910211-10-18-2019-04-CC-JMOA-BH3SMN-20191018140012

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 203910211
Report Date: 10/18/2019
Date Signed: 10/18/2019 02:00:17 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:	CORTES, MIRIAM FAMILY CHILD CARE		FACILITY NUMBER:	203910211
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	10/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Miriam Cortes		TIME COMPLETED:	02:00 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, Miriam Cortes and daughter. LPA explained the reason of the inspection and a tour of the home was conducted both inside and outside. LPA observed licensee caring for 1 child. During the inspection 1 child was picked up. Licensee stated that children have access to the living room, kitchen area, dining room, family room, 1 bathroom, and backyard. Licensee has placed children's plastic door knob (Spinners) on all the bedrooms doors so children don't have access to them. LPA observed plenty of age appropriate toys, a crib, cubbies, and small tables and chairs. LPA also observed that the day-care home was clean and free of toxins. The knives and medications are stored up high in a kitchen cabinet which are inaccessible to children in care. The cleaning supplies/toxins are stored inside garage which is off limits. LPA spoke about the safe sleep regulations that will take affect this year with the licensee 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. The bathroom was found clean and free of toxins during the inspection. The backyard has a fence that goes all around. LPA observed plenty of age appropriate toys and a basketball court. Licensee has a trampoline which is closed with Zip ties and states that only her own children use. Licensee has 3 dogs in the backyard and states that it doesn't have contact with children in care. Licensee understands responsibility of any action taken by pets involving day care children. Licensee has a 2A10 BC fire extinguisher that was purchased in October 16, 2019. LPA explained to licensee that she needs to get it serviced or replaced yearly. Licensees CPR/First Aid certificate is good until 06/17/2021. The last time Licensee conducted the fire/emergency drills with children was on 07/09/2019. Report continued onto LIC 809-C

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019

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: CORTES, MIRIAM FAMILY CHILD CARE	FACILITY NUMBER: 203910211
	VISIT DATE: 10/18/2019

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The carbon monoxide and smoke detector were tested and found in working condition. A Child's file was 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 and LPA did not observe any bodies of water during todays inspection. Licensee is current with the immunization requirements per SB 792. Mandated Reporter Training AB 1207 was taken on 02/28/18.

Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. 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, No deficiencies were observed.

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 Matsubara	TELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Juvenal Moctezuma	TELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019

LIC809 (FAS) - (06/04)

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