543905918-11-2-2022-57-CC-ROCA-CKSQJP-20221102121303

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543905918
Report Date: 11/02/2022
Date Signed: 11/02/2022 12:13:21 PM

Document Has Been Signed on 11/02/2022 12:13 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	MENDOZA, LUCIA FAMILY CHILD CARE		FACILITY NUMBER:	543905918
ADMINISTRATOR:	MENDOZA, LUCIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 783-2386
CITY:	PORTERVILLE	STATE: CA	ZIP CODE:	93257
CAPACITY:	14	CENSUS: 7	DATE:	11/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Lucia Mendoza		TIME COMPLETED:	12:30 PM

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On 11/2/2022, Licensing Program Analyst (LPA) Ruby Ocegueda, conducted an unannounced Annual Required Inspection and was met by Licensee, Lucia Mendoza. Also present was Staff #2 (S2). Licensee is Spanish Speaking and LPA Ocegueda assisted with interpretation. Days and hours of operation are Monday through Friday 5:00 AM and 6:00 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 living room, dining area and one hall bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of door knob safety covers. 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 is made inaccessible by a large entertainment center that blocks the whole fire place area and will not be in use during daycare hours. In the living room there was two heavy book cases that were not anchored and one of them was free standing. One book case was positioned in a way that prevented supervision of children and on one occasion, LPA saw a child hit another in the area. There is a working fire extinguisher, smoke detector, carbon monoxide detector and 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 559-783-2386

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. Provider physically checks on sleeping infants every fifteen minutes and documents 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 living room where licensee can visually observe them. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. Report continued to 809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby Ocegueda	TELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022

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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Document Has Been Signed on 11/02/2022 12:13 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MENDOZA, LUCIA FAMILY CHILD CARE	FACILITY NUMBER: 543905918
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/02/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(g)

Immunizations

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. LPA Ocegueda observed that child #2, child #3, child #4 and child #5 were missing proof of immunizations. Child #3 was also missing emergency contact information. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/16/2022
	Plan of Correction
1 2 3 4	Licensee stated she would obtain proof of immunizations and continue to obtain updated immunizations for the above children as well as ensure that files were complete with all forms filled out correctly and completely. Proof of immunizations for children #2, #3, #4 and #5 will be submitted to the Department by 11/2/2022.

Type B

Section Cited

CCR

102423(a)(2)

Personal Rights

(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above. LPA observed that there were two heavy wood bookshelves that were not anchored and shook easily. One was against the entertainment center and one was free standing. One of the bookshelves was positioned in such a way that it created a visual blind spot. Children were observed fighting in that area. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/16/2022
	Plan of Correction
1 2 3 4	Licensee stated that the Migrant Program she participates in requires her to create stations with the furniture. Licensee will coordinate with the Migrant Program to find another safer alternative to follow their requirements and stated she would anchor the bookshelves to the wall to prevent them from toppling over. Proof will be submitted to the Department by 11/16/2022.

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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby Ocegueda	TELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022

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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MENDOZA, LUCIA FAMILY CHILD CARE	FACILITY NUMBER: 543905918
	VISIT DATE: 11/02/2022

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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. Four of the Five files were missing proof of immunization's. Licensee’s Mandated Reporter Training was completed on 1/28/2022. Licensee’s pediatric CPR/First Aid expires on 7/2023. A review of records indicates that all employees and/or volunteers have 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 deficiencies are being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

Exit interview as conducted with licensee Lucia Mendoza. 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: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby Ocegueda	TELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022

LIC809 (FAS) - (06/04)

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