543806081-1-29-2020-04-CC-DDMZ-BLAMPZ-20200129084756

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543806081
Report Date: 01/28/2020
Date Signed: 01/29/2020 08:48:06 AM

COMPREHENSIVE INSPECTION

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:	CARDENAS, ALICIA FCC		FACILITY NUMBER:	543806081
ADMINISTRATOR:	CARDENAS, ALICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 528-0727
CITY:	OROSI	STATE: CA	ZIP CODE:	93647
CAPACITY:	14	CENSUS: 10	DATE:	01/28/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Alicia Cardenas		TIME COMPLETED:	05:00 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	"Spanish speaker" Licensing Program Analyst (LPA) Diana Martinez conducted an unannounced annual/random. LPA met with licensee Alicia Cardenas. Also present was assistant Laura Orozco. Ten children were present today. LPA conducted an interior and exterior tour of the home. The accessible rooms are the living room, dining room, kitchen, day care room (formerly the master bedroom) and master bathroom. The off-limit rooms are made inaccessible with key locks. Safe, healthful, and comfortable accommodations and furnishings were observed. Also observed were safe toys, play equipment, and materials. Licensee does not have any pets. There are no bodies of water or firearms in this home. Cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace in living room is inaccessible to children. Fireplace is not used during day care hours. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. There are no stairs in the home. There is a working landline telephone and number was verified. Ratio as specified on the license was not being maintained. Licensee has a current roster of the children and a copy is secured. Licensee maintains documentation of immunizations for the children. Licensee maintains documentation of immunizations against pertussis, measles and influenza for herself and assistant. Pediatric CPR/First Aid are current with the expiration date of 3/4/2020. Incidental Medical Services (IMS) are currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 (See next page)

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

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: CARDENAS, ALICIA FCC	FACILITY NUMBER: 543806081
	VISIT DATE: 01/28/2020

NARRATIVE

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Licensee is aware that she must provide parents with a copy of the Identification and Emergency Information form (LIC 700) and must verify that forms are completed and signed. Licensee is aware that fire drills are to be conducted and documented with the date and time every six months. Licensee is aware that children are never to be left in parked vehicles. 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 is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. 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 advance notice.

Days and hours of operation are Monday – Friday from 7:00 AM – 5:30 PM.

LPA reviewed and provided information to licensee regarding prohibited infant equipment, safe sleep, lead exposure, parents’ board, children's files and instructions on accessing PINs and quarterly updates. LPA discussed with licensee that if no assistant provider is present at a large FCCH, then licensee must comply with the capacity requirements for a small FCCH. LPA reviewed and provided licensee with the maximum capacity worksheet and age group/capacity example sheets to prevent an over capacity and/or ratio deficiency. Licensee was provided with a packet of licensing forms and drill log.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiencies are found (see 809D):

Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Copies of the Parent Notification Requirements(AB 633) and Acknowledgement of Receipt of Licensing Reports(LIC 9224) were provided to licensee. Licensee was provided a copy of appeal rights.

An exit interview conducted with licensee Alicia Cardenas and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: CARDENAS, ALICIA FCC	FACILITY NUMBER: 543806081
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/28/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/28/2020 Section Cited	1 2 3 4 5 6 7	Staffing Ratio and Capacity. The capacity specified on the license shall be the maximum number of children for whom care can be provided. This requirement was not met as evidenced by LPA's observation during today’s inspection. At 1:30 pm, LPA entered home and observed licensee and assistant with a total of 10 children (7 infants and 3 pre-school).
	8 9 10 11 12 13 14	Licensee indicated that she enrolled two additional infants this month. This poses an immediate risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14	Deficiency cleared during today's inspection; however, licensee agrees to submit a written statement to CCLD by 2/4/20 outlining how she will ensure she maintains the proper ratio and capacity.
Type A 01/28/2020 Section Cited	1 2 3 4 5 6 7	Personal Rights. Each child shall receive safe, healthful and comfortable accommodations, furnishing and equipment. This requirement was not met as evidenced by LPA's observation during today’s inspection. Licensee had two infants in strollers during naptime upon LPA’s arrival at 1:30 PM.
	8 9 10 11 12 13 14	Assistant was rocking strollers back and forth and indicated that this is the only way infants fall asleep. Licensee admitted that she was not aware that such equipment is prohibited in day care facilities. This poses an immediate risk to the health, safety, or personal rights of children in care.	8 9 10 11 12 13 14	Licensee agrees to nap the infants and children on cots or playpens and to place prohibited equipment in inaccessible rooms. Deficiency cleared during today's inspection.

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: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Diana D Martinez	TELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

LIC809 (FAS) - (06/04)

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