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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243901688
Report Date: 10/16/2019
Date Signed: 10/16/2019 09:23:20 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:TORREZ, HELENA & CARL FCCFACILITY NUMBER:
243901688
ADMINISTRATOR:TORREZ, HELENA & CARLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 383-1957
CITY:MERCEDSTATE: CAZIP CODE:
95348
CAPACITY:14CENSUS: 7DATE:
10/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Helena TorrezTIME COMPLETED:
09:45 AM
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Licensing Program Analyst (LPA) Ginny Badhesha conducted an unannounced annual inspection and met with Licensee, Helena Torrez. LPA explained the reason of the inspection and a tour of the home was conducted both inside and outside as shown on the facility sketches (LIC 999A). Present in the home was the Licensee, licensee’s husband, assistant and seven day care children. Fireplace is screened and inaccessible to children in care. There are no stairs in the home. LPA observed plenty of age appropriate toys in the day-care room and observed that the house was clean and free of toxins. The backyard has a fence that goes all around. LPA observed a wooden play structure and other age appropriate toys. There was plenty of shade. Licensee has no pets at this home. The last time Licensee conducted the fire/emergency drills with children was on 07/8/2019. Children's files were reviewed along with the children's roster and everything was completed and up to date. Licensee, licensee's husband and assistant are current with the immunization requirements per SB 792. Licensee, licensee's husband and assistant have taken the Mandated Reporter Training AB 1207. Licensees CPR/First Aid certificate is current and expires on August 25, 2020. LPA spoke about the safe sleep regulations with Licensee and reminded her to not store anything inside the cribs and playpens. LPA also provided licensee with a safe sleep brochure and the new lead brochure. Licensee has a 3A40 BC fire extinguisher, carbon monoxide detector and smoke detector. There was adequate heating and ventilation for safety and comfort. Firearms and ammunition are properly stored. There is a working telephone and number was verified. Capacity as specified on the license is being maintained.

Incidental Medical Services (IMS) policy was discussed. Licensee is aware that an IMS plan is required to be submitted to the Licensing office if they provide any of these services.

Days and hours of operation are Monday through Friday; 6:00am-6:00pm.



(Continued on 809-C)
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Gagandip BadheshaTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
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: TORREZ, HELENA & CARL FCC
FACILITY NUMBER: 243901688
VISIT DATE: 10/16/2019
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Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited today.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINS), Quarterly Updates, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Gagandip BadheshaTELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2