243908229-10-29-2019-04-CC-RGUZ-BHEQQL-20191029122230

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243908229
Report Date: 10/29/2019
Date Signed: 10/29/2019 12:22:41 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:	AVILA, RAQUEL & GEORGE FAMILY CHILD CARE		FACILITY NUMBER:	243908229
ADMINISTRATOR:	AVILA, RAQUEL & GEORGE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 675-9364
CITY:	LOS BANOS	STATE: CA	ZIP CODE:	93635
CAPACITY:	14	CENSUS: 9	DATE:	10/29/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Raquel Avila		TIME COMPLETED:	12:45 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	Licensing Program Analyst (LPA), Robert Gutierrez, conducted an unannounced annual inspection and was met by Licensees, Raquel Avila, George Avila and assistant Jonathan Avila. LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that the living room, dining room, kitchen, nook, bathroom adjacent to family room and backyard are accessible to children. Licensee stated when caring for children under the age of five she greets parents at the main entrance door and takes child(ren) to the split level family room. Children over the age of five have access to the kitchen, nook, dining room, and living room. Licensee was informed if she were to have children under the age of five in kitchen, living room, nook and dining room she must place a child safety gate at the base and top of the stair cases. All other rooms are off-limits and made inaccessible by use of plastic door knob spinners and safety gates. There are no swimming pools or other bodies of water on the premises. The outdoor play area in the backyard is fenced and there are no hazards to children present. There are no firearms or ammunition on the premises. Safe toys and play equipment are observed. Cleaning compounds, medication and other hazardous items are made inaccessible. No poisons were observed during inspection. Stairs leading up to the second floor and stairs at the base of the family room are barricaded when children under age 5 years old are present. The fireplace located in the family room is made inaccessible by a book shelf and will not be in use during daycare hours. There is working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Licensee has one dog inaccessible to children in care. This dog is kept in the dog run on the side of the facility. Licensee understands the liability and safety of children around pets and accepts responsibility. Capacity as specified on the license is being maintained. Licensee’s pediatric CPR/First Aid expires on 02/2020. Mr. Avila completed his Mandated Reported Training on 10/18/2019. Ms. Avila was unable to provide LPA with her mandated reporter training. An emergency fire/disaster drill has been completed within the last 6 months. A review of records indicates that immunization records are in file for children and adults. Licensee has a current roster of the children. LPA reviewed a sample of children’s file and observed files were complete. Licensee maintains emergency information and forms as required. Licensee has a working telephone and the above telephone number was verified. Adequate supervision is being provided during this visit. Continued on 809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019

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: AVILA, RAQUEL & GEORGE FAMILY CHILD CARE	FACILITY NUMBER: 243908229
	VISIT DATE: 10/29/2019

NARRATIVE

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There are no excluded individuals present at this home. Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and notification of parents rights poster are posted on the living room. Licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address. Days and hours of operation are Monday-Friday, 6:00 am to 7:00 pm.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide these services.
The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link
https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is found

(see next page): 809 D

Licensee was provided a copy of appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Inspection is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019

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: AVILA, RAQUEL & GEORGE FAMILY CHILD CARE	FACILITY NUMBER: 243908229
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/29/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/12/2019 Section Cited	1 2 3 4 5 6 7	Current proof of completion for each licensed child care provider or applicant for that license, administrator, and employee of a licensed child day care facility shall be submitted to the department upon inspection of the child day care or upon request by the department.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by a interview conducted with the Ms. Avila during today’s inspection. Upon inspection, Ms. Avila stated she took the training but could not provide LPA with her certificate. This poses as a potential risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 559-243-4588
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2019

LIC809 (FAS) - (06/04)

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