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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543802231
Report Date: 01/15/2020
Date Signed: 01/15/2020 04:39:27 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:MIMI'S MUNCHKINS DAY CAREFACILITY NUMBER:
543802231
ADMINISTRATOR:HAAS, NAOMI CHAVEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 635-0317
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 4DATE:
01/15/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Noami Chavez Haas- Licensee TIME COMPLETED:
05:00 PM
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An unannounced Annual/Random Inspection was conducted today by Licensing Program Analyst (LPA) Jessika Thompson. LPA with met with Licensee Naomi Chavez Haas and a census was taken. A tour of the facility was made. Background clearances were discussed, and licensee confirmed all adults residing and/or providing care and supervision have a criminal record clearance. Accessible areas of the home are the living room, dining room, kitchen, bedroom #1 and hallway bathroom. Off-limit rooms are made inaccessible by use of locked doors. The home is clean and orderly, with heating and ventilation for safety and comfort. There are no stairs in the home. Safe, healthful, and comfortable accommodations, furnishings, toys and equipment were observed. There is a working telephone. Licensee has two dogs that are inaccessible to children, as they are maintained within a kennel, or gated area of the backyard when children are present. Licensee accepts full liability for any action taken by family pets. A current roster of children in care is maintained. Licensee provides a copy of Parent’s Rights to all parents and/or child’s representatives. Licensee ensures that children in care are supervised at all times. There are no bodies of water or firearms on the premises. Facility has required fire extinguisher and smoke detector, both meet State Fire Marshall standards. Facility has one functioning carbon monoxide detector that meets statutory requirements. Licensee understands children may not be left in parked vehicles. Safe sleep practices for infants was discussed and LPA provided the licensee with a handout. Lead safety was discussed, and LPA provided Licensee with a brochure. Licensee understands that lead safety information must also be provided to parents and/or authorized representatives of children in care. Provider Information Notices were discussed, and licensee stated that she is subscribed to receive updates via email. Licensee is aware that forms and updated information may be obtained on the Department’s website (www.ccld.ca.gov). Licensee has proof of Child Abuse Mandated Reporter training, completed 10/29/18. Licensee was advised that this certification must be renewed every two years. Licensee understands that it is her responsibility to stay current with regulations. Licensee is urged to visit the U.S. Consumer Product Safety Commission web page at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled (Continued on LIC809-C).
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: MIMI'S MUNCHKINS DAY CARE
FACILITY NUMBER: 543802231
VISIT DATE: 01/15/2020
NARRATIVE
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Incidental Medical Services (IMS) are not currently being provided. Licensee was advised that if/when any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Licensee was advised that the Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).


Hours of operation are Monday through Friday from 7:00 AM to 5:30 PM and as arranged; less than 24 hours. Licensee is reminded of inspection authority by employees of the Department at any time, with or without advance notice.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found: (see LIC809-D)

In exit interview the licensee was advised of appeals rights and was provided with Appeals Rights. Licensee was also advised that this report with Type A Deficiencies must be posted for 30 days where parents may easily view and filed in facility file for public review for 3 years.



Licensee is advised to make this licensing report accessible to the public and to provide copies of this licensing report and LIC809-D with Type A citation to parents/legal guardians of children in care and to parents/legal guardians of children newly enrolled at the facility during the next 12 months. Licensee is to keep verification of receipt (LIC9224) in each child's file at the facility. An LIC9224 and Assembly Bill 633 fact sheet was provided to licensee on this date.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2020
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: MIMI'S MUNCHKINS DAY CARE
FACILITY NUMBER: 543802231
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/15/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/15/2020
Section Cited

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Poison, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger to children shall be stored where they are inaccessible to children. This requirement was not met, as evidenced by LPA's observations.
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During today's inspection, LPA observed (in areas accessible to children) the following items in the kitchen: two bottles of medication and two bottles of vitamins atop a counter; all purpose cleaner, detergents, and two containers of pesticide beneath the kitchen sink (the safety fixture attached to the cabinet was inoperable). All of the above listed items contain labels that state, "Keep out of reach of children". This poses an immediate health, safety, or personal rights risk to children in care.
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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 01/15/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/15/2020
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: MIMI'S MUNCHKINS DAY CARE
FACILITY NUMBER: 543802231
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/15/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/15/2020
Section Cited

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Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.
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This requirement was not met, as during today's inspection, the licensee was unable to provide immunization records for Child #1 and Child #2. This poses a potential risk to the health, safety, or personal rights of children in care.
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Type B
02/15/2020
Section Cited

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The Licensee and other personnel as specified shall complete training on preventive health practices including pediatric cardiopulmonary resuscitation (CPR) and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement was not met, as during records review today, LPA confirmed the licensee’s CPR and first aid card is expired. This poses a potential risk to the health, safety, or personal of children in care.
Type B
01/22/2020
Section Cited

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 The home shall be free from defects or conditions which might endanger a child. This requirement was not met, as today, LPA observed the following in accessible areas of the backyard: Several small piles of dog feces, a large ladder, two shovels, and a rake. This poses a potential risk to the health, safety, or personal rights of children in care.
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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 01/15/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/15/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4