243910450-3-2-2020-04-CC-RGUZ-BMBPRU-20200302103318

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243910450
Report Date: 03/02/2020
Date Signed: 03/02/2020 10:33:24 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:	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: 10	DATE:	03/02/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Lisa Wilson		TIME COMPLETED:	10:45 AM

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	On 03/02/2020 Licensing Program Analyst (LPA), Robert Gutierrez, conducted an unannounced required one-year annual inspection and was met by Licensee, Lisa Wilson also present was Staff #1 (S1). LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that the day care room, kitchen, dining room, living room, bedroom #1, laundry room and the side yard are accessible to children. Children access the side yard by going the front yard entrance. Licensee stated she fully supervises children while transitioning in and out the facility. All other rooms are off-limits and made inaccessible by use of plastic door knob spinners. Swimming pool is fenced per regulation. The pool gate is self-latching, self-closing and opens away from the swimming pool. No windows or doors have direct access to the pool area. 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 are barricaded when children under age 5 years old are present. The fireplace located in the living room 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 two dogs that are accessible to children. 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 02/08/2022. S1 pediatric CPR/First Aid expires on 02/2021. Licensee’s Mandated Reporter Training was completed on 04/30/2018. S1 Mandated Reporter Training was completed on 10/17/2019. 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. Licensee has a working telephone and the above telephone number was verified. Adequate supervision is being provided during this visit. 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. 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. Days and hours of operation are Monday - Friday, 7:00 am to 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: 03/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020

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: 03/02/2020

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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, no deficiencies were cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit 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: 03/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020

LIC809 (FAS) - (06/04)

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