503909484-1-4-2024-04-CC-VMIS-CZ6TBF-20240104133504

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503909484
Report Date: 01/04/2024
Date Signed: 01/04/2024 01:35:23 PM

Document Has Been Signed on 01/04/2024 01:35 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	VELASCO, MARIA ELENA FAMILY CHILD CARE		FACILITY NUMBER:	503909484
ADMINISTRATOR:	VELASCO, MARIA ELENA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 324-5906
CITY:	MODESTO	STATE: CA	ZIP CODE:	95355
CAPACITY:	14	CENSUS: 9	DATE:	01/04/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Maria Velsasco		TIME COMPLETED:	02:15 PM

NARRATIVE

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On 01/04/2024, Licensing Program Analyst (LPA) Valerie Mireles conducted an unannounced Triennual Required Inspection and was met by licensee, Maria Velasco. Also present was licensee’s assistant. LPA toured the home inside and outside and a census was taken. LPA observed 9 children in care. Days and hours of operation are Monday - Friday from 6:00 a.m. to 6:00 p.m.

LPA reviewed current facility sketch and confirmed that the kitchen, dining, living room, two bedrooms, and bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by door knob spinners. There is no swimming pool or other bodies of water on the premises. Licensee states that 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. There is one fireplace in the home located in the dining room and 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. Licensee conducts fire safety drills as required and last documented fire safety drill was conducted on 01/04/2024. This is a single level home and there are no stairs. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (209) 324-5906.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained. LPA reviewed a sample of children’s files and observed files were incomplete. During file review, LPA observed one infant file missing 15-minute sleep logs and LIC9227 form and another infant file, the last documented 15-minute safe sleep log was on 05/27/2023. All children’s files did have emergency information as required. Licensee’s Mandated Reporter Training was completed on 05/17/2023. Licensee’s pediatric CPR/First Aid certification expires on 11/18/2025. A review of staff records indicates that employees and/or volunteers did not have immunization records on file for influenza, pertussis and measles. Continued to LIC809-C.

SUPERVISOR'S NAME: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Valerie Mireles	TELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: VELASCO, MARIA ELENA FAMILY CHILD CARE	FACILITY NUMBER: 503909484
	VISIT DATE: 01/04/2024

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LPA discussed the Community Care Licensing (CCL) website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed safe sleep regulations with licensee and discussed the CCL Safe Sleep https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with licensee Maria Velasco. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see LIC809-D page). Licensee was provided appeal rights. 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: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Valerie Mireles	TELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/04/2024 01:35 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 RO, 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: 01/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(1)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, Licensee did not comply with the section cited above. There was no documentation that Licensee physically checking on Child #1 (CH1) every 15 minutes when CH1 was sleeping. Licensee had documentation for Child #2 (CH2); however, the last recorded 15-minute sleep log for CH2 05/26/2023. This poses a potential health, safety, or personal rights risk to children in care.
	POC Due Date: 01/18/2024
	Plan of Correction
1 2 3 4	Per Licensee, she agrees that she will physically check on CH1 and CH2 every 15 minutes when CH1 & CH2 are asleep and will document the checking on a safe sleep log. Licensee agrees to submit copy of safe sleep log showing two weeks of documentation to Fresno Community Care Licensing by the end of day 01/18/2024.

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee was unable to provide proof of her perttussis, measles and influenza immunizations for herself and her assistant. This poses a potential risk to the health, safety, or personal rights of children in care.
	POC Due Date: 01/18/2024
	Plan of Correction
1 2 3 4	Licensee states she will provide proof of immunization for the measles for herself and proof of immunization for measles, pertussis and influenza for Assistant #1 to the CCL Fresno Child Care Office by end of day on 01/18/2024.

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 Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Valerie Mireles	TELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/04/2024 01:35 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 RO, 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: 01/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above. Licensee did not have the LIC 9227 for infant (CH1) in care, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/18/2024
	Plan of Correction
1 2 3 4	Licensee will have parents complete the required Individual Infant Sleep Plan (LIC 9227) and will submit to CCLD by the POC due date of 01/18/2024. Original copy will be kept in child's file.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Valerie Mireles	TELEPHONE: (559) 341-5431
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

LIC809 (FAS) - (06/04)

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