543907665-6-7-2021-04-CC-TMAZ-C3RVXE-20210607164924

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543907665
Report Date: 06/07/2021
Date Signed: 06/07/2021 04:50:47 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:	BENEVEDES, CHRISTINE & MCCOY, MORIAH FCC		FACILITY NUMBER:	543907665
ADMINISTRATOR:	BENEVEDES, CHRISTINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 736-3790
CITY:	VISALIA	STATE: CA	ZIP CODE:	93277
CAPACITY:	14	CENSUS: 14	DATE:	06/07/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Christine Benevedes		TIME COMPLETED:	01:00 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 6/7/2021, Licensing Program Analyst (LPA) Theresa Marquez conducted an unannounced annual inspection and met with Licensee Christine Benevedes. Assistants Moriah McCoy and Savanna McCoy were also present. A tour of the home was conducted, and a census was taken. Business hours are Monday through Friday 4:30AM to 7:00PM. Current facility sketch reviewed, and Licensee confirmed the living room, the class room, kitchen/dining area, hall bathroom and fenced backyard. Off-limits rooms are made inaccessible via children’s safety gates. There was no fireplace. The home was kept clean and orderly, with heating and ventilation for safety and comfort. There were no stairs in the home. Safe toys and play equipment were observed. Licensee had a working telephone and the above telephone number was verified. LPA did not observe any poisons in the home. The fire extinguishers, smoke detectors, and carbon monoxide detectors met Community Care Licensing (CCL) regulations. The outdoor play area in the backyard is fenced and there are no hazards to day care children. Licensee ensures that children in care are supervised at all times. There was no swimming pool, bodies of water, or firearms on the premises. Licensee no longer accepts care for infants. Licensee is aware children shall not be left in parked vehicles and is aware car seats are used for transportation purposes only and are not used for sleeping children. LPA did discussed Safe Sleep Regulations with Licensee.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021

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: BENEVEDES, CHRISTINE & MCCOY, MORIAH FCC	FACILITY NUMBER: 543907665
	VISIT DATE: 06/07/2021

NARRATIVE

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A sample of children’s records contained all emergency information specified by regulation. There were no excluded individuals present at this home. All adults who reside or work in the home had a criminal record clearance or exemption. A review of records indicated Licensee and all employees have proof of required immunizations and written declaration declining flu shot. Licensee's Mandated Reporter Training was completed on 1/31/2022. Licensee's pediatric CPR and First Aid expires on 2/23/2022.

Adequate supervision was being provided during this inspection and capacity as specified on the license was being maintained.

Incidental Medical Services (IMS) are not currently 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. http://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 no deficiencies were observed today.

Licensee was provided a copy of the Facility Evaluation Report (LIC 809) and the Notice of Site Visit form (LIC 9213).

The LIC 809 is required to remain in the facility for public review and the LIC 9213 is required to be posted for 30 days.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2021

LIC809 (FAS) - (06/04)

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