<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543803770
Report Date: 08/22/2019
Date Signed: 08/26/2019 10:25:33 AM

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:LOPEZ, MARIA FAMILY CHILD CAREFACILITY NUMBER:
543803770
ADMINISTRATOR:LOPEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 688-4736
CITY:TULARESTATE: CAZIP CODE:
93274
CAPACITY:14CENSUS: 1DATE:
08/22/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Maria LopezTIME COMPLETED:
02:00 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
Licensee is a Spanish speaker. An unannounced Annual Random inspection was conducted at this Family Child Care Home by LPA Patricia Musso today. Right after LPA's arrival, licensee called her daughter, Maria Lopez to translate for licensee and LPA from Spanish to English to Spanish.
A tour of the home and grounds was conducted. Licensee is within capacity limit. Licensee said there were no weapons or poisons kept at the home. Licensee understands that weapons and poisons are to be locked not just inaccessible. Medications/cleaning compounds and other harmful items are stored in inaccessible areas. There is a working fire extinguisher, smoke detector and carbon monoxide detector and first aid kit are in place per regulation. There is adequate heating and ventilation for safety and comfort. Safe toys, safe indoor and outdoor play areas observed. Off-limit rooms are made inaccessible by using spinning plastic door knob covers. The home has a working phone. Outdoor play area is fenced. Discussed children shall be supervised at all times. There are no bodies of water on the premises during this inspection and licensee has no pets. Licensee is aware that any adults providing care and supervision or living in the home must be background cleared and LIS 531 was signed. Licensee maintains a copy of children's emergency information in children's files. Licensee has taken Mandated Reporter Training.
Licensees CPR and First Aid training are current. Fire drills have been conducted every month. Licensee understands that drills are required at least one, every 6 months and is to be documented with date and time. Postings are correct. Licensee is responsible to stay current with regulations and forms through the CCLD web site (www.ccld.ca.gov).
Incidental Medical Services (IMS) policy was discussed and a copy of the Plan Requirements was provided to licensee today. IMS was discussed with licensee on a previous inspection. LPA verified licensee's immunizations per SB792
Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, no deficiencies.

During exit interview LPA observed licensee post the Notice of Site Visit prior to leaving the facility and left instructions that it needs to be posted for 30 days.

SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2019
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 1