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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503910236
Report Date: 01/30/2020
Date Signed: 01/30/2020 03:45:28 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:VEGAS LOPEZ, JUNE FAMILY CHILD CAREFACILITY NUMBER:
503910236
ADMINISTRATOR:VEGAS LOPEZ, JUNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 585-5433
CITY:OAKDALESTATE: CAZIP CODE:
95361
CAPACITY:14CENSUS: 11DATE:
01/30/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:June Vegas LopezTIME COMPLETED:
04:15 PM
NARRATIVE
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An annual random inspection #2 is being conducted by LPA Claudia Henley. I was met by licensee and her two adult assistants. There were nine day care children and two biological grandchildren present. A tour of the home, inside and outside, as shown on the facility sketch is provided. Children were spoken to during visit. There are no "bodies of water" or firearms in this home. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children. There were door knob spinners on the doors of the rooms inaccessible to the children. Fire/disaster drill was conducted in January 2020. Fireplace is not used during day care hours and inaccessible. There is a working fire extinguisher, a smoke detector, carbon monoxide and there is adequate heating and ventilation for safety and comfort. Safe toys and play equipment are observed. There is a working telephone. Adequate supervision is being provided during this visit. Children are supervised when outside in the fenced play area. No pets on the premises. Capacity as specified on the license is being maintained. Staff-child ratios are maintained. 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. Pediatric CPR & Pediatric First/Aid is current on licensee until 7/2021. Eleven children's files were reviewed. Licensee has a current roster. No medication is given to the children. Staff files were reviewed. Licensee and one assistant is current on immunization. One assistant did not have record of immunization. Licensee and staff have completed the online Child Abuse Mandated Reporter Training.

The following is cited per Title 22 Regulations (see page 2). Appeal Rights left with licensee.

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: 01/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2020
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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: VEGAS LOPEZ, JUNE FAMILY CHILD CARE
FACILITY NUMBER: 503910236
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/30/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/28/2020
Section Cited

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Health & Safety Code - Section 1597.622: The Licensee and employees to have appropriate records for immunizations (Influenza, Pertussis & Measles).
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This requirement was not met as evidenced by: One assistant who was providing supervision today was not able to provide a copy of the required immunization records.
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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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:
DATE: 01/30/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/30/2020
LIC809 (FAS) - (06/04)
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