393601457-10-8-2019-53-CC-ASIS-BGRP89-20191008110510

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393601457
Report Date: 10/08/2019
Date Signed: 10/08/2019 11:05:24 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	ADELITA MIGRANT CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	393601457
ADMINISTRATOR:	RICO, ELIZABETH		FACILITY TYPE:	830
ADDRESS:	14320 EAST HARNEY LANE		TELEPHONE:	(209) 368-2087
CITY:	LODI	STATE: CA	ZIP CODE:	95240
CAPACITY:	30	CENSUS: 19	DATE:	10/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Elizabeth Rico		TIME COMPLETED:	11:15 AM

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Licensing Program Analyst (LPA) Alecia Sifuentes met with Director, Elizabeth Rico for the purpose of an unannounced annual random inspection. Director was reminded never to exceed the conditions, limitations and capacity specified on the license. Census included nineteen infants being supervised by nine staff members. Facility hours of operation are Monday through Friday from 5:00 AM to 4:30 PM.

LPA toured the building including all activity and classroom spaces, restrooms, food service, and outdoor play areas. Currently, no infants in care require medications. Poisons are not kept on premises. Toxic and hazardous items are inaccessible to children. Furniture and equipment are in good condition. Playground equipment and surfaces are free of loose or sharp parts. Infant changing tables have a padded surface that is washable and at least one-inch-thick, and they have raised sides that are at least three inches high. The floors appeared clean throughout the facility. The food preparation space is free of litter and all food was protected against contamination. LPA observed that storage containers for solid waste and diaper disposal have tight-fitting covers. LPA observed that the infant's bottles and meals are provided at the facility. Program provides breakfast, morning snack, lunch, and afternoon snacks for toddlers and infants who are on solids. Menus were posted and drinking water was readily available to children both indoors and outdoors.

LPA observed parents are signing in/out properly using the sing-in and out binders. LPA observed the infant's Needs and Services Plans are current. Two staff and three children's records were reviewed. Each child's file contained an emergency card, a medical assessment, and Needs and Services Plan. At least one staff member present today has current Pediatric CPR and First Aid certification (exp. 6/8/2020).

Report continues on 809-C.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: ADELITA MIGRANT CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 393601457
	VISIT DATE: 10/08/2019

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There are no firearms or bodies of water on the premises. LPA observed a functional carbon monoxide detector. LPA reviewed the Department's inspection authority and discussed with Director any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within ten working days.

This facility provides Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 verified the annual fees are current.

This facility evaluation report was reviewed and discussed with Director. A Notice of Site Visit was provided and should remain posted for a period of 30 days for parental review. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov. Director was encouraged to the visit the department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining child care centers.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Alecia Sifuentes	TELEPHONE: (916) 917-9202
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

LIC809 (FAS) - (06/04)

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