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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243808999
Report Date: 07/17/2019
Date Signed: 07/17/2019 01:04:04 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:CCCDS-RAFAEL L. SILVA MIGRANT CHILD DEVELOP. CTRFACILITY NUMBER:
243808999
ADMINISTRATOR:MENDOZA, MISTYFACILITY TYPE:
830
ADDRESS:18926 W HENRY MILLER RDTELEPHONE:
(209) 827-2783
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY:11CENSUS: 10DATE:
07/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Martha GutierrezTIME COMPLETED:
01:15 PM
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An unannounced Annual inspection was conducted today by Licensing Program Analysts (LPAs) Robert Gutierrez and Ruby Ocegueda. LPAs met with Site Supervisor, Martha Gutierrez. There are no bodies of water or firearms on the premises. Disinfectants, cleaning solutions are inaccessible to children. No poisons were observed during today’s inspection. Furniture and equipment are in good condition. The surface of the outdoor activity space is maintained in a safe condition, and is free of hazards. The licensee takes measures to keep the facility free of flies, other insects, and rodents. The facility has age-appropriate furniture and equipment including, but not limited to, cribs, cots, or mats. A baby walker is not allowed on the premises. The facility has sufficient infant napping equipment. The facility has indoor activity space for infants that is physically separate from space used by preschool children. The child care center is clean, safe, sanitary, and in good repair at all times. Facility has one or more functioning carbon monoxide detectors. Bottles, dishes, and containers of food brought by the infant's authorized representative are labeled with the infant's name and the current date. While in use, infant changing tables are placed within arm's reach of a sink. The facility ensures that each infant is never left unattended, and under the direct visual supervision of a staff person at all times. The facility is in compliance with the staff-infant ratios required. Prior to working or volunteering in a licensed child care facility, all individuals subject to criminal record review have obtained a clearance or criminal record exemption. The licensee ensures that personnel records are maintained on the licensee, administrator, and each employee. The facility ensures that staff being utilized as infant teachers during the compliance review meet the qualification requirements. Menus are posted at least one week in advance in a place visible by the child's authorized representative, dated, and kept on file for 30 days, and are made available on request. At least one person trained in Pediatric CPR and First Aid is present when children are at the facility or at offsite activities. The facility has an individual feeding plan for each infant that meets the requirements. Day and hours of operation are Monday through Friday; 8:00 AM to 4:30 PM.

Continued on 809-C

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert GutierrezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
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 2
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: CCCDS-RAFAEL L. SILVA MIGRANT CHILD DEVELOP. CTR
FACILITY NUMBER: 243808999
VISIT DATE: 07/17/2019
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This facility provides Incidental Medical Services – IMS. Currently there are no children requiring medication.. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

Per Chapter 1, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today.

Site Visit Notice posted on the parent board.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert GutierrezTELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2019
LIC809 (FAS) - (06/04)
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