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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243804595
Report Date: 04/28/2021
Date Signed: 04/28/2021 10:58:38 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:HAPPY FACE DAY CAREFACILITY NUMBER:
243804595
ADMINISTRATOR:REYES, ROSALINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 316-7631
CITY:MERCEDSTATE: CAZIP CODE:
95340
CAPACITY:14CENSUS: 3DATE:
04/28/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rosalinda Reyes - LicenseeTIME COMPLETED:
11:15 AM
NARRATIVE
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On 4/28/21, Licensing Program Analysts (LPAs) Joseph Pacheco and Jeovanna Yanez conducted an unannounced case management inspection. LPAs met with Licensee to discuss Community Care Licensing (CCL) regulations. LPAs discussed the purpose of the inspection with Licensee and obtained a census. Licensee is not maintaining children’s files in accordance with Title 22 regulations. Licensee was unable to provide required paperwork in children’s files. Licensee was unable to find a children’s roster during today’s inspection.

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

LPA provided Licensee with a copy of Appeal Rights. 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: 04/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2021
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: HAPPY FACE DAY CARE
FACILITY NUMBER: 243804595
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/05/2021
Section Cited

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Operation of a Family Child Care Home. All homes shall have a current roster of the children. This requirement was not met, as evidenced by records review. Licensee stated that she does not know where her children’s roster is and was unable to provide a copy during today’s inspection.
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This is a potential risk to the health, safety or personal rights of children in care.
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Type B
05/05/2021
Section Cited

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Operation of a Family Child Care Home. An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician
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and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement was not met as evidenced by Licensee stating that she does not have the required paperwork for children in care. This is 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: 04/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/28/2021
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: HAPPY FACE DAY CARE
FACILITY NUMBER: 243804595
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/05/2021
Section Cited

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Admission Procedures and Parental and Authorized Representative's Rights. The licensee shall request the child's parent or authorized representative to sign and date the bottom portion of the notice form LIC 995A (8/06), which acknowledges that the parent or authorized representative has received
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and read the LIC 995A. The bottom portion of this form must be kept in the child’s file. This requirement was not met as evidenced by Licensee stating that she does not have the required paperwork for children in care. This is 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: 04/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/28/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3