503809064-7-10-2019-04-CC-LGAN-BDXP93-20190710110627

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503809064
Report Date: 07/10/2019
Date Signed: 07/10/2019 11:06:36 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:	CLARKE, PAMELA FAMILY CHILD CARE		FACILITY NUMBER:	503809064
ADMINISTRATOR:	CLARKE, PAMELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 632-1545
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	14	CENSUS: 8	DATE:	07/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Pamela Clarke		TIME COMPLETED:	11:15 AM

NARRATIVE

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Licensing Program Analysts (LPAs), Luisa Gavoutian and Cynthia Brannon, conducted an unannounced annual/random inspection. LPAs were greeted by Licensee Pamela Clarke who accompanied LPAs on a tour of the home, inside and outside, as shown on the facility sketches (LIC 999) provided. Also present was fingerprint cleared assistant Athena Clarke. Present during today’s inspection were eight children. The areas of the home that are accessible to the daycare children are the living room, dining room, bathroom, kitchen, and fenced backyard. “Off-limits” rooms are made inaccessible by door knob spinners and child safety gate. One dog was observed during today’s inspection; licensee is aware of the safety of children around animals. There are no "bodies of water" in this home. Licensee stated there are no firearms in this home. Licensee stated there are no poisons on the premises. Cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is inaccessible to children by a cubby that is secured in front of the fireplace. There is a working fire extinguisher, which was last serviced on 01/13/2019. LPAs tested the smoke detector and carbon monoxide indicator, which were both in working condition. The home has adequate heating and ventilation for safety and comfort. Stairs are barricaded when children under age 5 years old are present. LPAs observed cobwebs on outdoor play equipment and furniture, broken down pile of wire fencing and rib steel roof panels, which Licensee stated used to be used for their chickens, a roll of carpeting, and dog feces in the accessible backyard.

There is a working telephone and cellphone number was verified. Adequate supervision is being provided during this inspection. Children are supervised when outside in the play area. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee maintains documentation of immunizations for children. Licensee maintains documentation of immunizations for herself and staff. 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.

(Continued on next page, LIC809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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: CLARKE, PAMELA FAMILY CHILD CARE	FACILITY NUMBER: 503809064
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/10/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/17/2019 Section Cited CCR 102417(g)	1 2 3 4 5 6 7	Operation of a Family Child Care Home; The home shall be free from defects or conditions which might endanger a child. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee is to clean cobwebs, remove roll of carpeting, wire fencing, rib steel roof panels, and ensure the dog feces are cleaned each morning prior to children having access to backyard. Licensee to submit pictures of above corrections to CCL by POC date 07/17/2019.
	8 9 10 11 12 13 14	Based on observation, Licensee failed to maintain the backyard free of defects including cobwebs on play equipment and furniture, dog feces on the lawn, spare roll of carpeting, pile of wire fencing and rib steel roof panels which were present in the accessible backyard.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	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: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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: CLARKE, PAMELA FAMILY CHILD CARE	FACILITY NUMBER: 503809064
	VISIT DATE: 07/10/2019

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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 are current expiring on 07/18/2020. Mandated reporter certificate is current expiring on 03/29/2020. 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 advanced notice. Days and hours of operation are Monday – Friday; 7:00 AM – 5:30 PM.

LPAs discussed Incidental Medical Services (IMS) and left the Plan for Providing Incidental Medical Services (IMS) – FCCH Requirements. 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.

LPAs & licensee discussed the Community Care Licensing (CCL) website: LPAs and licensee discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN. LPAs thoroughly discussed safe sleep practices and left a copy of A Child Care Provider’s Guide to Safe Sleep.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is found (see next page, LIC809-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 VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

LIC809 (FAS) - (06/04)

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