503910916-10-14-2021-04-CC-LGAN-C7SR7Z-20211014124710

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503910916
Report Date: 10/14/2021
Date Signed: 10/14/2021 12:47:28 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:	AWAZI, MARINA FAMILY CHILD CARE		FACILITY NUMBER:	503910916
ADMINISTRATOR:	AWAZI, MARINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 802-7401
CITY:	TURLOCK	STATE: CA	ZIP CODE:	95382
CAPACITY:	14	CENSUS: 12	DATE:	10/14/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Licensee Marina Awazi		TIME COMPLETED:	01:00 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 10/14/2021, Licensing Program Analyst (LPA), Luisa Gavoutian, conducted an unannounced Annual Inspection. LPA was greeted by Licensee Marina Awazi who accompanied LPA on a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. Also present were a fingerprint-cleared live-in adult relative and a fingerprint-cleared assistant. Present during today’s inspection were 12 children. The areas of the home that are accessible to the daycare children are the converted garage (daycare room), two bedrooms, hallway bathroom, and laundry room. “Off-limits” rooms are made inaccessible by child safety gate and doorknob spinners. No pets were observed during today's inspection. There are no bodies of water in this home. Licensee stated there are no firearms in this home. No poisons were observed during the inspection. Detergents, cleaning compounds, medications and other hazardous items are inaccessible to children. There is no fireplace. There is a working fire extinguisher. LPA tested the smoke detector and carbon monoxide indicator, which were both in working condition. The home has adequate heating and ventilation for safety and comfort. There are no stairs in the home. Safe toys and play equipment were 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 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 LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: AWAZI, MARINA FAMILY CHILD CARE	FACILITY NUMBER: 503910916
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/14/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(b)

Infant Safe Sleep

(b) Cribs or play yards shall be free from all loose articles and objects. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in one infant was observed sleeping with a pillow in the play yard which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/28/2021
	Plan of Correction
1 2 3 4	Licensee stated she shall complete the safe sleep training available through the Department's webpage and submit a written statement of understanding of infant safe sleep regulations to CCL by 10/28/2021.

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, the licensee did not comply with the section cited above in four out of four infant files reviewed did not maintain documentation of 15-minute checks which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/28/2021
	Plan of Correction
1 2 3 4	Licensee stated she shall begin documenting each 15 minute check for all infants under 24 months of age. Licensee will submit copies of sleep logs for each infant to CCL by 10/28/2021.

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 Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: AWAZI, MARINA FAMILY CHILD CARE	FACILITY NUMBER: 503910916
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/14/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(5)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in one infant was asleep in a bedroom with the door closed which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/28/2021
	Plan of Correction
1 2 3 4	Licensee stated she shall complete the safe sleep training available through the Department's webpage and submit a written statement of understanding of infant safe sleep regulations to CCL by 10/28/2021.

Type B

Section Cited

CCR

102423(a)(2)

Personal Rights

(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, Licensee did not ensure the personal rights of persons in care to safe and healthful accommodations in that Licensee and assistant did not wear face coverings while in the facility, as required by the CA Dept. of Public Health Guidance on the Use of Face Coverings issued June 18, 2020 and updated November 16, 2020, and an individual mask exception did not apply. This poses a potential health, safety, or personal rights risk to persons in care.
	POC Due Date: 10/28/2021
	Plan of Correction
1 2 3 4	Licensee stated she shall review the CDPH guidance for childcare setting and submit a written statement of understanding of COVID-19 guidelines including wearing of face coverings to CCL by 10/28/2021.

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 Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

LIC809 (FAS) - (06/04)

Page: 3 of 8

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: AWAZI, MARINA FAMILY CHILD CARE	FACILITY NUMBER: 503910916
	VISIT DATE: 10/14/2021

NARRATIVE

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During today’s inspection, LPA observed one infant asleep in a bedroom and the door to the bedroom was closed. Additionally, LPA observed a pillow in the play yard where the infant was sleeping. The infant woke up as soon as LPA and Licensee entered the bedroom. Licensee understands that no loose articles, including pillows and blankets, are allowed in the play yard when an infant under 24 months of age is sleeping and doors to rooms where infants are sleeping must remain open at all times so that Licensee can visually observe the infant without moving the door.

Adequate supervision is being provided during this inspection. LPA observed Licensee and her assistant do not wear face coverings and children age two and older are not taught and reminded to wear face coverings as required by the California Department of Public Health (CDPH) COVID-19 guidelines for childcare settings. Children are supervised when outside in the play area and there are no hazards to children present. Capacity as specified on the license is being maintained.

There is a working telephone and cellphone number was verified. LPA reviewed a sample of children’s files. LPA observed two of the 10 files reviewed did not contain ID and emergency contact information, and five of the 10 did not contain a signed parent’s rights form. LPA reviewed the files of the four infants present and found they did not contain documentation of 15-minute checks during nap. Licensee maintains documentation of immunizations for influenza, pertussis, and measles for herself and staff. Licensee’s Pediatric CPR/First Aid are current expiring on 06/14/2022. Licensee’s Mandated Reporter training certificate was completed on 02/21/2021. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advanced notice. Days and hours of operation are Monday – Friday; 6:30 a.m. – 6:00 p.m.

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.
(Continued on LIC 809-C)

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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: AWAZI, MARINA FAMILY CHILD CARE	FACILITY NUMBER: 503910916
	VISIT DATE: 10/14/2021

NARRATIVE

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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 & Licensee discussed the Community Care Licensing (CCL) website (www.ccld.ca.gov) which provides access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Forms, and Regulations. Licensee stated she is receiving PINs and updates through email.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D). Exit interview conducted and report was reviewed with the licensee Marina Awazi.

A notice of site visit was given and must remain posted for 30 days.

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.

SUPERVISOR'S NAME: Alice Juarez	TELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Luisa Gavoutian	TELEPHONE: (559) 341-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

LIC809 (FAS) - (06/04)

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