203910239-10-21-2022-04-CC-SVGZ-CKEW2M-20221021165434

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 203910239
Report Date: 10/21/2022
Date Signed: 10/21/2022 04:54:42 PM

Document Has Been Signed on 10/21/2022 04:54 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	CARDONA, YADIRA FAMILY CHILD CARE		FACILITY NUMBER:	203910239
ADMINISTRATOR:	CARDONA, YADIRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 706-6250
CITY:	MADERA	STATE: CA	ZIP CODE:	93638
CAPACITY:	14	CENSUS: 10	DATE:	10/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Yadira Cardona		TIME COMPLETED:	05:00 PM

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On 10/21/2022 Licensing Program Analyst (LPA), Stephanie Vega-Gonzalez, conducted an unannounced Annual Required Inspection and was met by Licensee, Yadira Cardona and Assistant. LPA explained the reason for the visit. Also present was Licensee’s Assistant (Staff #1). Days and hours of operation are Monday through Friday 6:00am to 6:00pm.

LPA toured the home inside and outside and a census was taken. Current facility sketch was reviewed, and Licensee confirmed that dining room, living room, hallway bathroom and backyard are used for providing care and are accessible to children. Backyard is accessible through side door in dining room area, which leads into the garage then to the backyard. Licensee stated that children are always supervised during transition. LPA observed that garage is inaccessible with a doorknob spinner and is locked. All other rooms are off-limits and made inaccessible by use of doorknob spinners and are locked. LPA did not observe a swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. LPA observed all poisons are kept in a locked storage area in hallway closet. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

LPA did not observe any fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. LPA observed licensee test the smoke detector and carbon monoxide. Licensee understands to test both smoke detector and carbon monoxide periodically for functionality. LPA did not observe any stairs in this home. The home has working telephone service and LPA confirmed the phone number is (559)706-6250.

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SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez	TELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2022

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: CARDONA, YADIRA FAMILY CHILD CARE	FACILITY NUMBER: 203910239
	VISIT DATE: 10/21/2022

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LPA observed an infant in care during inspection. Licensee stated she is caring for two infants. LPA observed one play yard in living room. Licensee stated that the second play yard is in off limit room and takes it out when second infant attends. Play yard is kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the play yard. License stated 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 provided Licensee with a copy of Safe Sleep Regulations. Licensee stated she will contact CCL if she has any questions regarding the Safe Sleep Regulations.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

Licensee updated her children’s roster during inspection. An emergency fire/disaster drill has been completed and documented within the last 6 months. Both Licensee and Assistant’s Mandated Reporter Training was completed on 03/17/2022. Both Licensee and Assistant’s pediatric CPR/First Aid expires on 10/01/2024. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

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SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez	TELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2022

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: CARDONA, YADIRA FAMILY CHILD CARE	FACILITY NUMBER: 203910239
	VISIT DATE: 10/21/2022

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Licensee Yadira Cardona 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.

LPA discussed the safe sleep regulations with Licensee Yadira Cardona 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.

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

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative Yadira Cardona.

SUPERVISOR'S NAME: Juvenal Moctezuma	TELEPHONE: (559) 650-7869
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez	TELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2022

LIC809 (FAS) - (06/04)

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