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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543907543
Report Date: 03/12/2020
Date Signed: 03/12/2020 03:46:04 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:BARRIOS, MARIA FAMILY CHILD CAREFACILITY NUMBER:
543907543
ADMINISTRATOR:BARRIOS, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 827-4775
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 11DATE:
03/12/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Maria Barrios - Licensee TIME COMPLETED:
03:45 PM
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On 03/12/20, Licensing Program Analyst (LPA) Jessika Thompson conducted an annual inspection. LPA with met with Licensee Maria Barrios and a census was taken. Also present was licensee’s assistant, Jose Aceves. A tour of the facility was made. Background clearances were discussed, and Licensee confirmed all adults residing and/or providing care and supervision have a criminal record clearance. Licensee has current pediatric CPR and First Aid that expire on 09/21/21. This is a two story home where the stairway is barricaded as required. Off limit rooms and/or areas are made inaccessible by use of spinning doorknob covers and baby gates. The home is clean and orderly, with heating and ventilation for safety and comfort. Safe, healthful, and comfortable accommodations, furnishings, toys and equipment were observed. A current roster of children in care is maintained. LPA verified that immunization records are maintained, and licensee updates records for children in care. Licensee provides a Notification of Parents’ Rights (LIC995A) to all parents of and/or authorized representatives. Licensee ensures that children in care are supervised at all times. Fire and disaster drills are conducted at least once every six months and documented with the date and time. There are no firearms or bodies of water on the premises. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are stored where they are inaccessible to children. Facility has required fire extinguisher and smoke detector, both meet State Fire Marshall standards. Facility has one functioning carbon monoxide detector that meets statutory requirements. Licensee understands children may not be left in parked vehicles. Safe sleep practices for infants in care was discussed. LPA verified Licensee provides lead safety information to parents and/or authorized representatives of children in care. Provider Information Notices were discussed, and licensee is subscribed to receive updates via email. Licensee is aware that forms and updated information may be obtained on the following website: www.ccld.ca.gov. Licensee maintains proof of Child Abuse Mandated Reporter Training, completed 11/04/19. Licensee was advised that this certification must be renewed every two years. Licensee understands that it is her responsibility to stay current with Title 22 Regulations.

(Continued on LIC809-C)
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020
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: BARRIOS, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 543907543
VISIT DATE: 03/12/2020
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Licensee was encouraged to visit the U.S. Consumer Product Safety Commission web page at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled.

Incidental Medical Services (IMS) are not currently being provided. Licensee was advised that if/when any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Licensee was advised that the Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).


Hours of operation are Monday through Friday from 6:45 AM to 6:00 PM, and as arranged; less than 24 hours. Licensee is reminded of inspection authority by employees of the Department at any time, with or without advance notice.

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

Licensee was advised that Notice of Site Visit (LIC9213) provided by LPA today is to remain posted for 30 days.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020
LIC809 (FAS) - (06/04)
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