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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543907665
Report Date: 05/24/2022
Date Signed: 05/25/2022 07:23:13 AM


Document Has Been Signed on 05/25/2022 07:23 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:BENEVEDES, CHRISTINE & MCCOY, MORIAH FCCFACILITY NUMBER:
543907665
ADMINISTRATOR:BENEVEDES, CHRISTINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
5597363790
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY:14CENSUS: 12DATE:
05/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Moriah McCoyTIME COMPLETED:
12:15 PM
NARRATIVE
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On 5/24/2022, Licensing Program Analyst (LPA) Theresa Marquez and Stephanie Vega-Gonzalez conducted an unannounced Required 1 year inspection and met with Licensee, Moriah McCoy. Assistant Savanna McCoy was also present. A tour of the home was conducted, and a census was taken. Current facility sketch reviewed, and Licensee confirmed the living room, family room, kitchen, dining area, hall bathroom and the 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, and safety gates.
Medications and other hazardous items were inaccessible to children. LPA did not observe any poisons in the home. The fire extinguishers, smoke detectors, and carbon monoxide detector met Community Care Licensing (CCL) regulations. There were no stairs in the home Staff-child ratios were maintained.
There are currently no infants in care. LPA discussed the safe sleep regulations with Moriah McCoy 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 licensee Moriah McCoy 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. Licensee ensures that children in care are supervised at all times. 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. Licensee has a pot belly pig that is inaccessible to children via fence and lock. 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.
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.
Continued on LIC809-C
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2022
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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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: 05/24/2022
NARRATIVE
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A sample of children’s records contained all emergency information specified by regulation. A review of records indicated Licensee and assistance have proof of required immunization (Pertussis/Measles/Influenza) and/or written declaration declining flu shot. Licensee's Mandated Reporter Training was completed on 01/06/2022. Licensee's pediatric CPR and First Aid expires on 02/03/2024.
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

Licensee Moriah McCoy 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.

Hours of operation are Monday through Friday 4:30 AM to 7:00 PM and other hours as arranged.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiencies were found; LPA Marquez and LPA Vega-Gonzalez observed the green artificial turf in the backyard play area is loosening and torn in some areas creating a tripping hazard for children. Nine of the twelve children present were not listed on the LIC9040 Child Roster. (see LIC809D):

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 at www.cdss.ca.gov/inforesources/community-care-licensing/process.
An exit interview was conducted and report was reviewed with the licensee Moriah McCoy. 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: 05/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 05/25/2022 07:23 AM - 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: BENEVEDES, CHRISTINE & MCCOY, MORIAH FCC
FACILITY NUMBER: 543907665

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. LPA Marquez and LPA Vega-Gonzalez observed the green artificial turf in the backyard play area is loosening and torn in some areas creating a tripping hazard for children. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/24/2022
Plan of Correction
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Licensee agrees to repair and/or replace and/or remove the green artificial turf by June 24, 2022. LPA Marquez will return for plan of correction inspection.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6


Document Has Been Signed on 05/25/2022 07:23 AM - 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710


FACILITY NAME: BENEVEDES, CHRISTINE & MCCOY, MORIAH FCC
FACILITY NUMBER: 543907665

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(8)
Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. Nine of the twelve chldren present were not listed on the LIC9040 Child Roster which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/25/2022
Plan of Correction
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Licensee will update the LIC9040 Child Care facility roster. Licensee is to submit evidence of updated LIC9040 to the Fresno licensing office by 5/25/2022.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:
DATE: 05/24/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/24/2022
LIC809 (FAS) - (06/04)
Page: 6 of 6