543806081-7-16-2021-04-CC-ROCA-C4YT9Q-20210716143219

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543806081
Report Date: 07/16/2021
Date Signed: 07/16/2021 02:32:32 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:	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: 3	DATE:	07/16/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Cardenas, Alicia		TIME COMPLETED:	02:45 PM

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On 07/16/2021, Licensing Program Analyst (LPA), Ocegueda conducted an unannounced Annual Required Inspection and was met by Licensee, Alicia Cardnas. Also present was Staff #1 (S1). Licensee is Spanish Speaking. Before entering the home, LPA Ocegueda conducted a Covid-19 safety screening. Days and hours of operation are Monday through Friday 7:00 AM – 5:00 PM or other hours as arranged.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that the kitchen, living room, master bedroom, master bathroom and back yard are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of door locks. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

The fireplace located in the living room and is made inaccessible by a glass door, and will not be in use during daycare hours. There is a working fire extinguisher, and per licensee the smoke detector, carbon monoxide detector are functioning and there is adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559) 528-0727.

LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. LPA discussed requirement for provider to physically check on sleeping infants every fifteen minutes and to document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants sleep in the master bedroom and licensee or S1 are in the room while they nap. Individual Infant Sleep Plan was reviewed and LPA informed licensee the form should be in each file of children under 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Report continued on 809-C

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Ruby Ocegueda	TELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021

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: CARDENAS, ALICIA FCC	FACILITY NUMBER: 543806081
	VISIT DATE: 07/16/2021

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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was not completed. Licensee’s pediatric CPR/First Aid expires on 2/8/2022. A review of records indicates that licensee has proof of immunization records on file for influenza, pertussis and measles.

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.

Incidental Medical Services (IMS) are not 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. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency was cited (see 809-D). Appeal rights were provided.

Exit interview was conducted with licensee Alicia Cardenas. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Michael Duarte	TELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Ruby Ocegueda	TELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021

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: CARDENAS, ALICIA FCC	FACILITY NUMBER: 543806081
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/16/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/13/2021 Section Cited	1 2 3 4 5 6 7	On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider...or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal...every two years.
	8 9 10 11 12 13 14	..he or she completed the initial mandated reporter training. This requirement was not met as evidenced by: record review and interview. Licensee and S1 did not have proof of required AB1207 training. This poses a potential risk to the health, safety and/or personal rights of children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Ruby Ocegueda	TELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2021

LIC809 (FAS) - (06/04)

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