503909757-3-6-2023-04-CC-JBAA-CPNULU-20230306144118

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503909757
Report Date: 03/06/2023
Date Signed: 03/06/2023 02:41:36 PM

Document Has Been Signed on 03/06/2023 02:41 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:	RUELAS-VARGAS, DALILA FAMILY CHILD CARE		FACILITY NUMBER:	503909757
ADMINISTRATOR:	RUELAS-VARGAS, DALILA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 505-4009
CITY:	PATTERSON	STATE: CA	ZIP CODE:	95363
CAPACITY:	14	CENSUS: 11	DATE:	03/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Dalila Ruelas Vargas		TIME COMPLETED:	03:00 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 3/6/2023 Licensing Program Analysts (LPA) Julie Baptista and Araceli Gibson, conducted an unannounced Annual Required Inspection and was met by Licensee, Dalila Ruelas Vargas. Also present was/were Staff #1 (S1) and Staff #2 (S1). Licensee is Spanish Speaking and bilingual and LPA Gibson assisted with interpretation. Days and hours of operation are Monday through Saturday 5:00 AM – 7:00 PM. The home has working telephone service and LPA confirmed the phone number is (209) 505-4009. LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed, and Licensee confirmed that the dining area, bathroom, living room and back yard are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of spinners. The outdoor play area in the backyard is fenced and there are no hazards to children present. LPA Baptista discussed with licensee play structures should be monitored for wear and tear or broken parts periodically. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. All poisons are kept in a locked storage area. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There are no fireplaces or open face heaters in the home. 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. 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 consulted with licensee completing safe sleep plan for all infants in care upon enrollment. 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. Continued on 809-C

SUPERVISOR'S NAME: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Julie Baptista	TELEPHONE: (559) 767-0213
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023

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 03/06/2023 02:41 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: RUELAS-VARGAS, DALILA FAMILY CHILD CARE	FACILITY NUMBER: 503909757
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/06/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(7)

Operation of A Family Child Care Home

(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in two out of four records reviewed which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/16/2023
	Plan of Correction
1 2 3 4	Licensee agrees to provide completed Emergency Consent Form to Fresno CCLD office by Plan of Correction date 3/16/2023. Form to be completed by authorized representative and a copy of completed form to be submitted by POC date.

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: Julie Baptista	TELEPHONE: (559) 767-0213
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023

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: RUELAS-VARGAS, DALILA FAMILY CHILD CARE	FACILITY NUMBER: 503909757
	VISIT DATE: 03/06/2023

NARRATIVE

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Licensee ensures that children in care are supervised at all times and is aware 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.
LPA reviewed a sample of children’s files and observed 2 children’s files did not have a completed LIC 627 Consent for Emergency Medical Treatment form. See 809-D. Licensee’s Mandated Reporter Training was completed on 6/03/2021. Licensee’s pediatric CPR/First Aid expires on 6/05/2023. A review of records indicates that all employees and/or volunteers 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)

Cont on 809-C

SUPERVISOR'S NAME: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Julie Baptista	TELEPHONE: (559) 767-0213
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023

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: RUELAS-VARGAS, DALILA FAMILY CHILD CARE	FACILITY NUMBER: 503909757
	VISIT DATE: 03/06/2023

NARRATIVE

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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 deficiencies is being cited: (see next page, 809 D). Appeal rights were provided.
Exit interview conducted and report was reviewed with the facility representative Dalila Ruelas Vargas.
A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Cynthia Brannon	TELEPHONE: (559) 650-7884
LICENSING EVALUATOR NAME: Julie Baptista	TELEPHONE: (559) 767-0213
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023

LIC809 (FAS) - (06/04)

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