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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503904421
Report Date: 10/16/2019
Date Signed: 10/16/2019 01:00:49 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:LICHTY, ANITA FAMILY CHILD CAREFACILITY NUMBER:
503904421
ADMINISTRATOR:LICHTY, ANITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 529-1518
CITY:MODESTOSTATE: CAZIP CODE:
95354
CAPACITY:14CENSUS: 5DATE:
10/16/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Anita LichtyTIME COMPLETED:
01:15 PM
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On this date, Licensing Program Analyst (LPA), Theresa Marquez, conducted an unannounced annual inspection and was met by Licensee, Anita Lichty. Also present was her daughter/Assistant Serena McKee. LPA toured the home inside and outside and a census was taken. Licensee has a working telephone and the above telephone number was verified.

Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and Notification of Parents Rights poster are posted on day care room wall.

Current facility sketch reviewed, and Licensee confirmed that the day care room, living room, hall bathroom, and bedroom # are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of door locks and children safety gates. Safe toys and play equipment are observed. There are no stairs in this home. The fireplace located in the living room is made inaccessible and will not be in use during daycare hours. There is working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Cleaning compounds, medication and other hazardous items are made inaccessible. There are no firearms or ammunition on the premises. All poisons are kept in a locked storage area. No poisons were observed during inspection.

The outdoor play area in the backyard is fenced. There are no swimming pools or other bodies of water on the premises. Licensee has two small dogs that are accessible to children. Licensee understands the liability and safety of children around pets and accepts responsibility.

Capacity as specified on the license is being maintained. Licensee’s pediatric CPR/First Aid expires on 3/17/2021. An emergency fire/disaster drill has been completed within the last 6 months.

Hours of operation are Monday-Sunday, various times of day or night.

(Continued on LIC809-C)

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: LICHTY, ANITA FAMILY CHILD CARE
FACILITY NUMBER: 503904421
VISIT DATE: 10/16/2019
NARRATIVE
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A review of records indicates that immunization records are in file for children and adults. Licensee has a current roster of the children and maintains emergency information and forms as required. Adequate supervision is being provided during this visit. All adults who reside or work in the home have a criminal record clearance or exemption.

This facility provides Incidental Medical Services (IMS). LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. Licensee to complete an IMS plan and submit to the Fresno CCL office by November 15, 2019.



The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301 (voice) and (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINS), Quarterly Updates, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are found (see next page): LIC809-D A copy of Licensee Appeal Rights was provided to Anita Lichty today.

This report shall be made available to the public upon request.

LIC 9213 Notice of Site Inspection is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: LICHTY, ANITA FAMILY CHILD CARE
FACILITY NUMBER: 503904421
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/23/2019
Section Cited

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IMMUNIZATIONS - The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.
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This requirement was not met as evidenced by record review. Licensee has 3 children enrolled and present on this day and she could not provide copies of immunization records of none of the 3 children. This poses a potential risk to the Health, Safety and Personal Rights to children in care.
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Type B
10/23/2019
Section Cited

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TRAINING FOR MANDATED REPORTER - On or before 3/30/2018, a person who, on 1/1/2018, is a licensed child care provider, admin., or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every 2 years following the date on which he or she completed the initial mandated reporter training.
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This requirement was not met as evidenced by interview and record review. Licensee could not provide evidence of completing the required Mand. Reporter Training. This poses a potential Health, Safety, Personal Rights risk to children in care.
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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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3