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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543906899
Report Date: 05/07/2019
Date Signed: 05/08/2019 12:52:34 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:MAGANA, MARIBEL FAMILY CHILD CAREFACILITY NUMBER:
543906899
ADMINISTRATOR:MAGANA, MARIBELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 553-3134
CITY:TULARESTATE: CAZIP CODE:
93274
CAPACITY:14CENSUS: 7DATE:
05/07/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Maribel MaganaTIME COMPLETED:
11:55 AM
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An unannounced Annual Random inspection was conducted at this Family Child Care Home by LPAs Patricia Musso and Diana Martinez today.
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 and a baby gate.
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. Licensee has a 2 small dogs and licensee understands that she is responsible for child safety around pets at all times.
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 are conducted as required at least every 6 months and 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. Licensee stated she does not administer medication to any children at this time.

Hours of operation are Monday - Friday, 5:30 AM to 5:30 PM
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2019
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: MAGANA, MARIBEL FAMILY CHILD CARE
FACILITY NUMBER: 543906899
VISIT DATE: 05/07/2019
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LPA & licensee discussed the Community Care Licensing website and Mandated Reporter Training: LPA and licensee discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

LPAs verified that immunizations per SB792 are current with all employees.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, there are no deficiencies.

During exit interview LPAs observed licensee post the Notice of Site Visit prior to leaving the facility and instructed license to post for 30 days. This report needs to be maintained
in the facility file for public review for 3 years. Licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Patricia MussoTELEPHONE: (559) 341-5422
LICENSING EVALUATOR SIGNATURE:

DATE: 05/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2019
LIC809 (FAS) - (06/04)
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