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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503909484
Report Date: 05/10/2023
Date Signed: 05/10/2023 01:49:50 PM


Document Has Been Signed on 05/10/2023 01:49 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710



FACILITY NAME:VELASCO, MARIA ELENA FAMILY CHILD CAREFACILITY NUMBER:
503909484
ADMINISTRATOR:VELASCO, MARIA ELENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 324-5906
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY:14CENSUS: 10DATE:
05/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Maria VelascoTIME COMPLETED:
02:00 PM
NARRATIVE
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On 5/10/23, Licensing Program Analyst (LPA) Priscilla Zamudio, conducted an unannounced Annual Required Inspection and was met by Licensee, Maria Elena Velasco. Also present were two assistants. Although Licensee speaks English, she is also Spanish Speaking and LPA assisted with interpretation. Days and hours of operation are Monday-Friday, 6:00AM-6:00PM .
LPA toured the home inside and outside and a census was taken. LPA observed 10 children. Current facility sketch reviewed and Licensee confirmed that the kitchen, dining, living rooms, two bedrooms, and bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of door knob spinners. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.
The fireplace located near the kitchen is made inaccessible by a screen, and will not be in use during daycare hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (209) 324-5906.
There were 3 infants in care. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles.
Continued on LIC 809-C...
SUPERVISOR'S NAME: Cynthia BrannonTELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla ZamudioTELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/04/2023
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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Document Has Been Signed on 05/10/2023 01:49 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: VELASCO, MARIA ELENA FAMILY CHILD CARE

FACILITY NUMBER: 503909484

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 05/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, 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 two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as she and her two assistants did not have updated mandated reporter training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/17/2023
Plan of Correction
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Licensee stated that she and her assistants will complete mandated reporter training and submit verification to licensing by POC due date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Cynthia BrannonTELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla ZamudioTELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/10/2023
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
FRESNO-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: VELASCO, MARIA ELENA FAMILY CHILD CARE
FACILITY NUMBER: 503909484
VISIT DATE: 05/10/2023
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Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. There are no pets on the premises. Capacity as specified on the license is being maintained.
LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was completed on 12/2/18. Licensee’s pediatric CPR/First Aid expires on 7/22/24. A review of records indicates that all employees and/or volunteers did not have immunization records on file for influenza, pertussis and measles.
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 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Incidental Medical Services (IMS) are not currently being provided. Incidental Medical Services (IMS) policy was discussed. 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 and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D)
Exit interview conducted and report was reviewed with licensee Maria Elena Velasco.
A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Cynthia BrannonTELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Priscilla ZamudioTELEPHONE: (559) 578-7350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2023
LIC809 (FAS) - (06/04)
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