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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543908443
Report Date: 11/21/2019
Date Signed: 11/25/2019 10:05:11 AM

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:PENA, JANIE FAMILY CHILD CAREFACILITY NUMBER:
543908443
ADMINISTRATOR:PENA, JANIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 741-1966
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 11DATE:
11/21/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Janie Pena - Licensee TIME COMPLETED:
04:00 PM
NARRATIVE
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On this date, Licensing Program Analyst (LPA) Jessika Thompson conducted a Case Management inspection. LPA Thompson met with licensee, Janie Pena . Also present were eleven day-care children. The purpose of this visit was to address a deficiency discovered at the facility, after further review of the licensee's pool gate specifications was conducted by LPA and discussed with management.

Today, LPA found that the self latching device on one of the licensee's pool gates was approximately 22 inches from the top of the gate. The licensee indicated that she has not made any alterations to the aforementioned gate since initial licensure on 01/08/13. The licensee was advised that although her current gate may have been approved by a Department Representative in years prior, because the latching device is not located less than six inches from the top of the gate, its current state poses a risk to the health, safety or personal rights of children in care.

Exit interview was conducted and appeal rights were discussed.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiency is cited:

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

DATE: 11/21/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2019
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: PENA, JANIE FAMILY CHILD CARE
FACILITY NUMBER: 543908443
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/21/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/28/2019
Section Cited

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The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water
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through a pool cover or by surrounding the pool with a fence. Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use. This requirement was not met, as evidenced by LPA observations. Today, LPA observed the latching device on one of the licensee's pool gate to be approximately 22 inches from the top of the gate. This poses a potential risk to the health, safety, or personal rights of children in care.
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LPA will conduct a subsequent inspection, on or after 11/28/19, to ensure the above correction has been made.

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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: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 11/21/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/21/2019
LIC809 (FAS) - (06/04)
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