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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503903875
Report Date: 06/21/2019
Date Signed: 06/21/2019 03:40:45 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:CRUZ, JOSIE FAMILY CHILD CAREFACILITY NUMBER:
503903875
ADMINISTRATOR:CRUZ, JOSIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 892-5767
CITY:PATTERSONSTATE: CAZIP CODE:
95363
CAPACITY:14CENSUS: 5DATE:
06/21/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Josie CruzTIME COMPLETED:
04:15 PM
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An annual random inspection #3 is being conducted by LPA Claudia Henley. LPA was met by licensee and licensee's minor assistant. There were five day care children present in the home. A tour of the facility was conducted. There are no "bodies of water" or firearms in this home. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is not used during day care hours. There is a working smoke detector, carbon monoxide, fire extinguisher and there is adequate heating and ventilation for safety and comfort. This is a second story home and the children do not have access to the second story. The areas were children have access to are: One large playroom and a hall way bathroom downstairs only. Licensee stated that the children do not have access to any other part of the home and a gate is installed to keep them from the other areas of the home. Safe toys and play equipment are observed. There is a working telephone. Licensee had proof that a fire/disaster drill had been conducted within the last six months. Adequate supervision is being provided during this visit. Children are supervised when outside in the fenced play area. There are two dogs on the premises. One small dog is inside and accessible to the children and the large dog is inaccessible and is outdoors or in the garage. Licensee is aware of the liability when it comes to pets on the premises. Capacity as specified on the license is being maintained. Staff-child ratios are maintained. All adults who are residing or working in the home have a criminal record clearance or exemption. No medication is being given. Children files were reviewed. Licensee's son Angel Martin is excluded from the home and the LIC995B "Family Child Care Home Addendum to the Parents' Rights" is signed by the parent and in the children's files. Licensee's CPR & First Aid certifications are valid until 12/2019. Licensee is current on immunization. Licensee completed the Child Abuse Mandated Reporter Training. The child care hours and days of operation are: Monday through Friday, 6:00 a.m. to 6:00 p.m. and Saturdays from 8:00 a.m. to 2:00 p.m.

No deficiences were cited during the inspection today. Site Visit Notice posted on the parent board. Exit interview conducted.
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2019
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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