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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243910981
Report Date: 01/07/2020
Date Signed: 01/07/2020 02:02:32 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:BARRIENTOS, ALICIA FAMILY CHILD CAREFACILITY NUMBER:
243910981
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
01/07/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Alicia Barrientos - LicenseeTIME COMPLETED:
02:30 PM
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An unannounced Case Management inspection was conducted today by Licensing Program Analyst (LPA) Joseph Pacheco. The purpose of today's visit was to conduct a post licensing follow-up on the initial pre-licensing visit that took place on 6/27/2019. LPA met with Licensee, Alicia Barrientos. A tour of the facility inside and outside was made. Five day-care children were present on this date. This is a two-story home and the upstairs is made inaccessible to children with a gate. The accessible rooms are the living room #1, living room #2, kitchen, and downstairs bathroom. Off-limit rooms are made inaccessible by the use of gates. Licensee’s CPR and first aid training expires 8/11/2020. Licensee is aware that a child's roster is to be maintained. The required forms are posted. Licensee has one dog that is inaccessible to day-care children. Licensee accepts liability of any action taken by pets. Licensee was advised that forms and updated information may be obtained on the CCLD website (www.ccld.ca.gov). Licensee was also advised that it is her responsibility to stay current with regulations. AB 1207 Child Abuse Mandated Reporter training was discussed and Licensee was provided with a handout.

Incidental Medical Services (IMS) policy was discussed. 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.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations no deficiencies were cited today. Exit interview was conducted with Licensee.



LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Joseph PachecoTELEPHONE: (559) 341-4457
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020
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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