243800117-12-3-2019-04-CC-NLOI-BJJ2JX-20191203162703

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243800117
Report Date: 12/02/2019
Date Signed: 12/03/2019 04:27:10 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:	CHAVEZ, ELIA FAMILY CHILD CARE		FACILITY NUMBER:	243800117
ADMINISTRATOR:	CHAVEZ, ELIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 358-2745
CITY:	ATWATER	STATE: CA	ZIP CODE:	95301
CAPACITY:	12	CENSUS: 6	DATE:	12/02/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Elia Chavez		TIME COMPLETED:	04:30 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	An unannounced Annual/Random inspection was conducted today by Licensing Program Analyst, Norma Lomeli. Present during the inspection was Spanish-speaking Licensee, Elia Chavez and six day-care children. Licensee and her two adult sons reside in the home. Background clearances were discussed and licensee signed LIS531 indicating all adults residing and/or providing care and supervision have a criminal record clearance. The licensee has current pediatric CPR and First Aid that was completed through EMS Safety with EMSA certified stickers and expires on 2/9/2021. Preventative Health and Safety certification was completed and confirmed at pre-licensing inspection. The home has heating and ventilation for safety and comfort. LPA observed children size furniture, books and safe toys for the children. Also observed was a diaper changing table, two play yards and a high chair. A current roster of children in care is maintained. Verified that immunizations records are maintained and license updates records for children in care. Licensee provides a copy of Parent’s Rights to all parents and/or child’s representative. The licensee ensures that children in care are supervised at all times. Fire and disaster drills are conducted at least once every six months, and documented with the date and time. Licensee states there are no weapons, firearms, ammunition or poisons in the home. Detergents, cleaning compounds, medications and other items which could pose a danger to children are stored where they are inaccessible to children. There is a fireplace in the living room that is not used during day-care hours. (Continued on LIC809-C):

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2019

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: CHAVEZ, ELIA FAMILY CHILD CARE	FACILITY NUMBER: 243800117
	VISIT DATE: 12/02/2019

NARRATIVE

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Facility has 2A10BC fire extinguisher and smoke detectors that meet State Fire Marshall standards. Facility has a working carbon monoxide detector that meets the statutory requirements.
Licensee states that the backyard is inaccessible to the day care children during the fall and winter months. Licensee states that the door that leads to the backyard is kept locked during day care hours. LPA observed that door is locked.
No bodies of water observed in or on the premises.
Licensee states she maintains licensed capacity at all times.
Licensee is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a).

LPA & licensee discussed the Community Care Licensing website: LPA and licensee discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

Hours or operation are Monday through Saturday from 7:00 AM to 6:00 PM and as arranged; less than 24 hours. Licensee is reminded of inspection authority by employees of the Department at any time, with or without advance notice. Licensee understands children may not be left in parked vehicles. When temporarily absent from the home, the licensee arranges for a substitute adult to care for and supervise children in her/his absence.

During exit interview, LPA observed licensee post the Notice of Site Visit on parent’s board and understands it must remain posted for 30 days and retain evaluation report for 3 years.

In the areas that were evaluated no deficiencies were observed at the time of the inspection.

SUPERVISOR'S NAME: Duane Matsubara	TELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Norma Lomeli	TELEPHONE: (559)650-7870
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2019

LIC809 (FAS) - (06/04)

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