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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543807458
Report Date: 04/28/2022
Date Signed: 04/28/2022 11:40:35 AM


Document Has Been Signed on 04/28/2022 11:40 AM - It Cannot Be Edited

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:NELSON, MARY FAMILY CHILD CAREFACILITY NUMBER:
543807458
ADMINISTRATOR:NELSON, MARYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 735-9772
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY:14CENSUS: 6DATE:
04/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Mary NelsonTIME COMPLETED:
12:00 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 4/28/2022, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced Required 1 year inspection and met with Licensee, Mary Nelson. A tour of the home was conducted, and a census was taken. Current facility sketch reviewed, and Licensee confirmed the day-care room, office area, bathroom and fenced backyard are used for providing care and are accessible to day care children. All other rooms are off-limits and are made inaccessible by use of spinner knobs.

Hours of operation are Monday through Friday 7:30 AM to 5:30 PM.

Medications and other hazardous items were inaccessible to children. LPA did not observe any poisons in the home. There was no fireplace. The fire extinguishers, smoke detectors, and carbon monoxide detector met Community Care Licensing (CCL) regulations. Heating/cooling and ventilation was sufficient for safety and comfort. There were no stairs in the home. Safe toys and play equipment were observed. Capacity as specified on the license was being maintained.
LPA discussed the safe sleep regulations with Mary Nelson 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 Nelson 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.

The outdoor play area in the backyard is fenced and there are no hazards to day care children. Licensee has 1 dog that is accessible to children. Licensee is aware of child safety around pets and accepts responsibility for any action taken by pets. There were no swimming pools, bodies of water, or firearms on the premises. Continued on LIC809-C
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/28/2022
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 2


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: NELSON, MARY FAMILY CHILD CARE
FACILITY NUMBER: 543807458
VISIT DATE: 04/28/2022
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
26
27
28
29
30
31
32
A sample of children’s records contained all emergency information specified by regulation. Licensee's Mandated Reporter Training was completed on 3/4/2021. Licensee's pediatric CPR and First Aid expires on 3/6/2023.

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

Mary Nelson 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, 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.
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.

Hours of operation are Monday through Friday 7:30 AM to 5:30 PM.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations no deficiencies were observed today.

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 www.cdss.ca.gov/inforesources/community-care-licensing/process.

An exit interview was conducted and report was reviewed with the Mary Nelson. A copy of Appeal Rights and the Notice of Site Visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2