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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 223910603
Report Date: 06/26/2019
Date Signed: 06/26/2019 10:02:00 AM

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:MUNSON, KENDRA FAMILY CHILD CAREFACILITY NUMBER:
223910603
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
06/26/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Kendra MunsonTIME COMPLETED:
10:30 AM
NARRATIVE
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 Licensing Program Analyst (LPA) Brannon conducted a case management inspection. Upon arriving, LPA observed an adult female #1 with licensee's children. Licensee was not present in the home due to picking up day care children. Per licensee, adult #1 is only present in the home to provide care to her children while she is in town picking up day care children. LPA reviewed with licensee that adult #1 cannot be present in the home when day care children arrive. Adult #1 cannot assist licensee due to not being fingerprinted cleared and meeting the requirements for adults working with child, as stated in Title 22, Division 12, Chapter 3.
During today's visit, LPA observed an unlocked tool shed. In the tool shed, licensee keeps her garbage and other miscellaneous items. During visit, LPA did not observe poisons accessible to children. LPA did observe rat/mice droppings. Per licensee, she is outside with the children and does not allow the children to leave the play area that is next to the unlocked shed. Per licensee, she is unable to lock the door. LPA is recommending that licensee install a locking device to ensure children do not enter the shed.
During today's inspection, LPA observed dishes in the sink, dried food items on stove and counter top that appeared to be sauce, food on the kitchen, living room and dining room floors. During today's inspection, LPA observed three infants walking and crawling on the floors. LPA observed toys were cluttered in an area. LPA observed pizza boxes on the kitchen table, and left over food in a bag on the kitchen table.
Per California Code of Regulations Title 22, this deficiency to be cited. Exit interview conducted with the licensee, Kendra Munson. POC/Appeal Rights were given and discussed. A copy of this report shall be placed in facility file for public review. A Notice of Site Visit was posted on parent board.

A COPY OF THIS REPORT IS TO REMAIN IN THE FACILITY FOR PUBLIC REVIEW. THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
To order forms, etc. visit our website at www.ccld.ca.gov
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
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: MUNSON, KENDRA FAMILY CHILD CARE
FACILITY NUMBER: 223910603
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/10/2019
Section Cited
CCR
102417(b)
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Operation of a Family Child Care Home. The home shall be kept clean and orderly, with heating and ventilation for safety and comfort. This requirement was not meet as evidenced by LPA's observation of dishes in the sink, dried food items on stove and counter top that appeared to be sauce, food on the kitchen, living room and dining room floors. During today's inspection, LPA observed three infants walking and crawling on the
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Per licensee, she will keep the home clean and orderly. LPA will conduct a return visit after 7/10/19.
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floors. LPA observed toys were cluttered in an area. LPA observed pizza boxes on the kitchen table, and left over food in a bag on the kitchen table. This is a potential health, safety and personal rights 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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Cynthia BrannonTELEPHONE: (559) 341-5155
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2019
LIC809 (FAS) - (06/04)
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