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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203910239
Report Date: 05/21/2019
Date Signed: 05/21/2019 03:15:25 PM

COMPREHENSIVE INSPECTION
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:CARDONA, YADIRA FAMILY CHILD CAREFACILITY NUMBER:
203910239
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
05/21/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Yadira CardonaTIME COMPLETED:
03:35 PM
NARRATIVE
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Licensing program Analyst (LPA) Juvenal Moctezuma conducted an unannounced Annual/Random Inspection. LPA met with licensees boyfriend, Luis Enrique Ramirez and explained to him the reason of the inspection. LPA observed 3 children sleeping in cots in the living room and asked Luis Enrique if Licensee, Yadira Cardona was home. Luis Enrique stated that the licensee was out picking up other children from school and he was left home caring for 3 day-care children and his son. LPA explained the reason of the inspection and asked to come into the home. Luis Enrique allowed LPA to come into the home. LPA called the licensee whom stated that she will be coming back in approximately 30 minutes. LPA waited in the living room with Luis Enrique while the licensee came home. Approximately 20 minutes later, another child was dropped off by the bus.

Approximately 30 minutes later, licensee arrived with 3 additional children. LPA explained to her the reason of the inspection and a tour of the home was conducted both inside and outside. Licensee sated that the children have access to her living room, dining room, one bathroom and backyard. LPA explained that since she doesn't have a gate that prevents children from going into her kitchen, that area is also considered accessible to children. Upon Arrival LPA observed all her bedroom doors open. Licensee stated that they are all inaccessible. LPA explained to licensee that if she wants to keep them inaccessible, then the bedroom doors need to remain closed/locked during day-care hours. The knives are stored on top of the refrigerator making them inaccessible to children in care. Medications, cleaning supplies, and toxins are stored in licensees hallway closet which is remained closed and locked. The bathroom was observed to be clean and free of toxins during the inspection. Licensee has her washer and dryer in the bathroom. LPA reminded licensee to not store anything on top of her washer/dryer.

The backyard has a fence that goes all around. LPA observed plenty of shade and grass area so children can play. LPA reminded licensee to put away all her gardening tools when she's done using them and to make sure they are stored in an area where children don't have access to them. LPA spoke about the safe sleep regulations that will take affect this year (2019) with 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. Report continued onto LIC 809-C
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
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 4
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: CARDONA, YADIRA FAMILY CHILD CARE
FACILITY NUMBER: 203910239
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/22/2019
Section Cited
CCR
102370(d)(1)&(e)
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Criminal Record Clearance- All individuals subject to a criminal record review as specified in Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption as required by the Department.
Violation of Section 102370(d) will result in a citation of a deficiency and an immediate
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Licensee stated that she will get Luis Enrique Ramirez fingerprint cleared and submit proof to CCL. LPA explained that anyone who is 18 years or older needs to be fingerprint cleared prior to residing in her home.
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assessment of civil penalties of one hundred dollars ($100) per violation per day for a maximum of five (5) days by the Department. This requirement was not met as evidenced by Licensee failing to get Luis Enrique Ramirez livescanned before residing in her home. This poses an immediate health/safety risk to children in care
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Licensee will write a plan of correction stating how this will not happen again and submit a written copy to CCL by no later than 05/22/2019.
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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: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CARDONA, YADIRA FAMILY CHILD CARE
FACILITY NUMBER: 203910239
VISIT DATE: 05/21/2019
NARRATIVE
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The smoke alarm & Carbon Monoxide were tested and found in working condition. Licensee has a 2 A 10BC Fire extinguisher that was giving to her back in 2017. LPA reminded licensee that fire extinguishers need to be serviced or replaced yearly. Yadira Cardona has proof that her CPR/First Aid certificate is current and doesn't expire till 08/04/2020. Licensee conducted the fire and disaster drills on 02/04/2019. 4 children's files were reviewed along with the roster and everything was completed and up to date.

Licensee stated that there are no guns or ammunition in the home. LPA did not observe any bodies of water during the inspection. Licensee has taken the mandated reporter training AB 1207 on 02/16/2018. During the Inspection, it was found that licensees boyfriend has been residing in her home without a prior fingerprint clearance. An immediate civil penalty assessed of $500.00 for failure to obtain a criminal record clearance for licensees boyfriend who resides in the home.

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 A and Type B Deficiencies were cited. Appeals rights were explained and provided to Licensee, Yadira Cardona.

Upon receipt of this report, licensee shall post for 30 days and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.

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 deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: CARDONA, YADIRA FAMILY CHILD CARE
FACILITY NUMBER: 203910239
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/31/2019
Section Cited
CCR
102416(c)
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Personnel Requirements- The Licensee and other personnel as specified shall complete training on preventive health practices including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
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Licensee stated that Luis Enrique will be her assistant and will sign him up for a CPR/First Aid class. Licensee will submit a plan of correction stating how this will not happen again and submit a copy to CCL by no later than 05/31/2019.
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This requirement was not met as evidence by LPAs observation and Luis Enrique stating that he was left alone caring for day-care children without having CPR/First Aid. This poses a potential health/safety risk to children in care.
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Type B
05/31/2019
Section Cited
CCR
102369(b)(9)
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Evidence of a current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home, for any adult in the home during the time that children are under care. This requirement was not met as evidence by Licensee
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Licensee stated that Luis Enrique will go and get a TB Test and submit proof to CCL by no later than 05/31/2019.
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not having proof that Luis Enrique Ramirez has a current TB test. This poses a potential health/safety risk to 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: Juvenal MoctezumaTELEPHONE: (559) 580-0275
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4