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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243804280
Report Date: 11/13/2019
Date Signed: 11/13/2019 02:42:08 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:NOT THE MAMA DAY CAREFACILITY NUMBER:
243804280
ADMINISTRATOR:HERNANDEZ, BERTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 631-1226
CITY:PLANADASTATE: CAZIP CODE:
95365
CAPACITY:14CENSUS: 4DATE:
11/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Bertha Hernandez - LicenseeTIME COMPLETED:
03:00 PM
NARRATIVE
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Licensing Program Analysts (LPAs), Joseph Pacheco and Jose Penate, conducted an unannounced Annual/Random inspection today. LPAs met with Licensee, Bertha Hernandez, toured the home and census was taken. Staff were spoken to during visit. There are no "bodies of water" or firearms in this home. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children. There is no fireplace. There is a working fire extinguisher, smoke and carbon monoxide detector, and there is adequate heating and ventilation for safety and comfort. There are no stairs in the home. There is a working telephone. Adequate supervision is being provided during this visit. The backyard of the home if off-limits to day care children. Licensee has dogs that are inaccessible to children via being kept in off-limits areas of the home. Licensee is aware of child safety around pets and accepts responsibility for any action taken by pets. Capacity as specified on the license is being maintained. Staff-child ratios are maintained. Licensee has a current roster of the children. Fire drills are conducted and documented with the date and time every six months. 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. Pediatric CPR/First Aid are current and expire on 01/19/2020. AB 1207 Mandated Reporter training has not been completed. Immunization's for staff was reviewed and verified.

Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. 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



An exit interview was conducted with Licensee. LPAs provided Licensee with information regarding providing incidental medical services to children, the CDSS Provider Information Notices (PINs) communication system, and some important resources and information links offered on the CDSS website.

CONTINUED ON LIC809-C
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019
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 3
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: NOT THE MAMA DAY CARE
FACILITY NUMBER: 243804280
VISIT DATE: 11/13/2019
NARRATIVE
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Lead safety information was provided in accordance with AB 2370, Chapter 676, Statues of 2018.

Hours of operation are Monday through Friday 2:30pm - 6:30pm. Saturday and Sunday 9:00am – 5:00pm.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found (LIC809-D):

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: NOT THE MAMA DAY CARE
FACILITY NUMBER: 243804280
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/13/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/04/2019
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider…of a licensed child day care facility shall complete the mandated reporter training…and shall complete renewal mandated reporter training every two years following the date on which he or she
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completed the initial mandated reporter training. This requirement was not met as evidenced by LPA observation. Licensee stated to LPA that she has not completed the required AB 1207 Mandated Reporter training. This poses a potential risk to the health, safety or personal rights of 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: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:
DATE: 11/13/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/13/2019
LIC809 (FAS) - (06/04)
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