503903527-7-26-2021-04-CC-LGAN-C5ATWT-20210726150604

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503903527
Report Date: 07/26/2021
Date Signed: 07/26/2021 03:06:11 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:	LOPEZ, REINA FAMILY CHILD CARE		FACILITY NUMBER:	503903527
ADMINISTRATOR:	LOPEZ, REINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 918-0778
CITY:	RIVERBANK	STATE: CA	ZIP CODE:	95367
CAPACITY:	14	CENSUS: 0	DATE:	07/26/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Reina Lopez		TIME COMPLETED:	03:15 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	On 07/26/2021, Licensing Program Analysts (LPAs), Luisa Gavoutian and Nancy Her, conducted an unannounced Annual Inspection. LPAs were greeted by Licensee Reina Lopez who accompanied LPAs on a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. Also present were Licensee’s minor child, and a fingerprint-cleared live-in adult relative. No daycare children were present during this inspection. Licensee has not had children enrolled since March 2020 and does not expect to have any children enrolled until August 2021. The areas of the home that are accessible to the daycare children are the daycare room, family room, kitchen, and hallway bathroom. “Off-limits” rooms are made inaccessible by doorknob spinners. Two dogs and two 50-gallon fish tanks were observed during today’s inspection; Licensee is aware of the safety of children around animals. Licensee stated there are no firearms in this home. An in-ground swimming pool is being constructed in the backyard and Licensee shall notify Community Care Licensing (CCL) upon project completion for an inspection. The backyard is made “off-limits” to daycare children effective immediately and requires an inspection prior to children being allowed access. No poisons were observed during the inspection. Detergents, cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is inaccessible to children by a metal screen and glass door and will not be in use during daycare hours. There is a working fire extinguisher. 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. Safe toys and play equipment were observed. (Continued on LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

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: LOPEZ, REINA FAMILY CHILD CARE	FACILITY NUMBER: 503903527
	VISIT DATE: 07/26/2021

NARRATIVE

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There are currently no infants in care. LPAs discussed Safe Sleep Regulations with Licensee. Licensee understands that there shall be one crib or play yard for each infant in care, cribs and play yards shall be kept free from all loose articles and objects while infants are sleeping, and there shall be no objects hanging above or attached to the crib or play yard. Infants shall not be swaddled while in care. Infants up to 12 months of age shall be placed on their backs for sleeping. Licensee shall physically check on sleeping infants every 15 minutes and document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants shall be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan shall be completed and in file for each infant up to 12 months of age.

There is a working telephone and cellphone number was verified. Adequate supervision is being provided during this inspection. Licensee is aware that children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Capacity as specified on the license is being maintained.

LPAs reviewed a sample of children’s files, which were complete with emergency information as required. Licensee maintains documentation of immunizations for influenza, pertussis, and measles for herself and staff. Licensee’s Pediatric CPR/First Aid are current expiring on 08/13/2021. Licensee was unable to produce a valid Mandated Reporter training certificate but stated it is scheduled to be renewed in August 2021. Licensee shall complete the training and submit a copy of the certificate to CCL. 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; 7:30 a.m. – 4:30 p.m.

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.
(Continued on LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

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: LOPEZ, REINA FAMILY CHILD CARE	FACILITY NUMBER: 503903527
	VISIT DATE: 07/26/2021

NARRATIVE

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This facility does not provide Incidental Medical Services – IMS. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disabilities Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPAs & Licensee discussed the Community Care Licensing (CCL) website (www.ccld.ca.gov) which provides access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Forms, and Regulations. Licensee stated she is receiving PINs and updates through email.

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: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

LIC809 (FAS) - (06/04)

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