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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543908003
Report Date: 05/09/2023
Date Signed: 05/09/2023 03:31:38 PM


Document Has Been Signed on 05/09/2023 03:31 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:VELTE, MALINDA & TEDDIE FAMILY CHILD CAREFACILITY NUMBER:
543908003
ADMINISTRATOR:VELTE, MALINDA & TEDDIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 539-5750
CITY:SPRINGVILLESTATE: CAZIP CODE:
93265
CAPACITY:14CENSUS: 11DATE:
05/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Teddie VelteTIME COMPLETED:
03:45 PM
NARRATIVE
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On 05/09/2023, Licensing Program Analyst (LPA), Jose Penate, conducted an unannounced Annual Required Inspection and was met by Licensee, Teddie Velte and assistants. Days/Hours of operation: Mon-Fri 7:00 AM to 6:00 PM.

LPA toured the home inside and outside and a census was taken. This facility is licensed as a large facility of 14, there must be an additional qualified staff person present anytime the facility goes beyond the ratio for a capacity of eight. The entrance to the facility is the door adjacent to the front entrance. LPA toured the facility inside and outside. Current facility sketch was reviewed, and Licensee confirmed that Classroom #1, Classroom #2, Classroom #3, living room, kitchen, and backyard are used for providing care and are accessible to children. During inspection LPA observed in Classroom #1 and Classroom #2 to have boxes, toy houses, binders, music equipment, and arts and crafts supplies on high shelving that could potentially fall over a child in care. All other rooms are off-limits and made inaccessible by use of child locks. No poisons were observed during the inspection.



There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. The home has working telephone service and LPA confirmed the phone number is 559-539-5750.

LPA and licensee discussed Safe Sleep Regulations. Licensee is aware that cribs and play yards are to be 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.

Provider is aware to physically check 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. Individual Infant Sleeping Plan is to be completed for each infant up to 12 months of age upon enrollment. LPA discussed with licensee, Infants up to 12 months of age shall be placed on their backs for sleeping.

(Continued on 809-C)
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7


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: VELTE, MALINDA & TEDDIE FAMILY CHILD CARE
FACILITY NUMBER: 543908003
VISIT DATE: 05/09/2023
NARRATIVE
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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. 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. During children's file review for Infant #1, form LIC 9227 was not completed by licensee or child representative. LPA discussed with licensee that the form must be completed for infant in care for ages 0-12 months. Licensees Mandated Reporter Training was completed on 04/19/2021 and is currently expired. Licensee’s pediatric CPR/First Aid expires on 03/15/2025. 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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, deficiencies being cited (See LIC809-D).

Exit interview conducted and report was reviewed with Licensee, Teddie Velte.

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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023
LIC809 (FAS) - (06/04)
Page: 2 of 7
Document Has Been Signed on 05/09/2023 03:31 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: VELTE, MALINDA & TEDDIE FAMILY CHILD CARE
FACILITY NUMBER: 543908003

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(b)
Operation of A Family Child Care Home
(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.

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 observed boxes, toys houses, binders, music equipment, and arts and crafts supplies on high shelving that could potentially fall over a child in care. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/19/2023
Plan of Correction
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Licensee will remove all items listed and any other dangers that are located in high areas.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

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. Licensee last completed mandated reporter training on 4/19/2021, and is currently expired. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/19/2023
Plan of Correction
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Licensee and staff will complete mandated reporter training and submit certification on or before POC date. (5/19/2023)
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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7


Document Has Been Signed on 05/09/2023 03:31 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: VELTE, MALINDA & TEDDIE FAMILY CHILD CARE
FACILITY NUMBER: 543908003

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/09/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

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. Licensee was unaware of form LIC 9227 to be completed for infants (0-12months). Licensee currently has 1 infant 12 months of age that has been enrolled into her program since 5 months of age. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/19/2023
Plan of Correction
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Licensee will complete form and have childs representative complete it as well and submit proof to CCL by POC date. (5/19/23)
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: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:
DATE: 05/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/09/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7