243910450-7-17-2019-04-CC-RGUZ-BE6UMB-20190717154203

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243910450
Report Date: 07/17/2019
Date Signed: 07/17/2019 03:42:10 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:	WILSON, LISA FAMILY CHILD CARE		FACILITY NUMBER:	243910450
ADMINISTRATOR:	WILSON, LISA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 704-2679
CITY:	LOS BANOS	STATE: CA	ZIP CODE:	93635
CAPACITY:	14	CENSUS: 7	DATE:	07/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Lisa Wilson		TIME COMPLETED:	04:00 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 Analysts (LPAs) Robert Gutierrez and Ruby Ocegueda conducted an unannounced annual inspection. LPAs met with Licensee Lisa Wilson. LPAs conducted a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. The rooms accessible to children in care are the day care room, kitchen, dining room, living room, bedroom #1 hallway bathroom and the side yard. Off-limits rooms/areas are made inaccessible via plastic door knob spinners. Two dogs and one bunny were observed during today’s inspection; licensee is aware of the safety of children around animals. There are no firearms in this home. Swimming pool is fenced per regulation. The pool gate is self-latching, self-closing and opens away from the swimming pool. No bedroom windows or doors have direct access to the pool area. No poisons were observed on the premises. Cleaning compounds, medications and other hazardous items are inaccessible to children. LPAs inspected kitchen and restroom cabinets and drawers and did not see items that could pose danger to children in care. Fireplace located in the living room is not used during day care hours. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. Stairs are barricaded when children under age 5 years old are present. There is a working telephone (209) 704-2679 and number was verified. Adequate supervision is being provided during this inspection. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee maintains documentation of immunizations for the children. Licensee maintains documentation of immunizations for pertussis, measles and influenza for herself. Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Fire drills are conducted and documented with the date and time every six months. Licensee is aware that children are never to be left in parked vehicles. 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. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Pediatric CPR/First Aid is current and expires 03/2020. Mandated Reporter training AB 1207 is current and expires 04/30/2020. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and notification of parents rights poster are posted on the day care room wall. 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; 7:00 AM – 4:30 PM. 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: 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)

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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: WILSON, LISA FAMILY CHILD CARE	FACILITY NUMBER: 243910450
	VISIT DATE: 07/17/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

LPA & licensee discussed safe sleep regulations and lead information.

LPA left a copy of LIC 9227.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Robert Gutierrez	TELEPHONE: 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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