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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543908752
Report Date: 11/17/2023
Date Signed: 11/17/2023 02:44:13 PM


Document Has Been Signed on 11/17/2023 02:44 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:HERNANDEZ, GLORIA FAMILY CHILD CAREFACILITY NUMBER:
543908752
ADMINISTRATOR:HERNANDEZ, GLORIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 310-9969
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:14CENSUS: 7DATE:
11/17/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Gloria HernandezTIME COMPLETED:
03:00 PM
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On 11/17/2023, Licensing Program Analyst (LPA), Ruby Ocegueda conducted an unannounced Annual Required Inspection and was met by licensee Gloria Hernandez. Also present was licensees assistant. Licensee is Spanish Speaking and LPA Ocegueda conducted todays inspection in Spanish. Days and hours of operation are from 5:00 AM to 6:00 PM.

LPA toured the home inside and outside and a census was taken. LPA reviewed current facility sketch and confirmed that the living room, kitchen, one bathroom and day care room. living room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of a baby gate, top door locks and door knob spinners.

There is a built-in swimming pool in the backyard which is fenced and made inaccessible. The pool gate is self-latching, self-closing and opens away from the swimming pool. No windows or doors have direct access to the pool area.

There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort.

This is a single level home and there are no stairs. Safe toys and play equipment are observed. Today, LPA observed that the kitchen counters and kitchen table were cluttered with multiple objects. On top of the kitchen counters were multiple prescription medication and vitamins. In the accessible bathroom there were multiple bottes of hand sanitizer and disinfectant wipes. In the day care room were two pack and plays that were dirty on top where children place their hands and mouths. Licensee stated she had not washed them since purchasing one year ago. The home has working telephone service and LPA confirmed the phone number is (559) 310-9969. Report continued to 809-C

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2023
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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Document Has Been Signed on 11/17/2023 02:44 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: HERNANDEZ, GLORIA FAMILY CHILD CARE
FACILITY NUMBER: 543908752

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2023

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 and interview, the licensee did not comply with the section cited above. It was observed that the kitchen counters had multiple objects, food products, pots, pans and dishes. It was difficult for LPA to inspect the counters due to the excess clutter and food debris. In the day care room, LPA observed that the two pack and plays were stained and dirty. Licensee stated that she had not washed them. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/01/2023
Plan of Correction
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Today, licensee cleared the counters. Licensee stated she would clear her table and the rest of her counters to reduce clutter. Licensee stated that she would wash the pack and plays to remove stains. Proof will be submitted by POC date : 12/1/2023.
Type B
Section Cited
CCR
102417(g)(4)
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: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

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 approximately two large bottles of hand sanitizer on the bottom of a bathroom sink. There were approximately 8 bottles inside a bathroom sink drawer. In the accessible kitchen, there were multiple prescription medications and vitamins on the counter. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/01/2023
Plan of Correction
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Today, Licensee removed the hand sanitizer bottles and placed them in inacessible areas. Licensee also removed medications and vitamins from the kitchen counter. Licensee stated she would complete a written statement indicating how she plans on keeping hazerdous items off limits to day care children. Proof of written statement will be provided by POC date : 11/17/2023.
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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/17/2023 02:44 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: HERNANDEZ, GLORIA FAMILY CHILD CARE
FACILITY NUMBER: 543908752

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2023

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. Today, infant #6 did not have Individual Infant Sleep Plan LIC 9227. This poses potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/01/2023
Plan of Correction
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Licensee stated she would submit a copy of Individual Infant Sleep plan for child #6 by POC date 12/1/2023.
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: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2023
LIC809 (FAS) - (06/04)
Page: 3 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: HERNANDEZ, GLORIA FAMILY CHILD CARE
FACILITY NUMBER: 543908752
VISIT DATE: 11/17/2023
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. The outdoor play area in the front yard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files today. Licensee could not find the file of child #6. Licensee’s Mandated Reporter Training was completed on 5/25/2023. Licensee’s pediatric CPR/First Aid certification expires on 2/11/2025. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Report continued to 809-C

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC809 (FAS) - (06/04)
Page: 6 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: HERNANDEZ, GLORIA FAMILY CHILD CARE
FACILITY NUMBER: 543908752
VISIT DATE: 11/17/2023
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Exit interview conducted and report was reviewed with licensee Gloria Hernandez. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page). Licensee was provided appeal rights.

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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC809 (FAS) - (06/04)
Page: 7 of 7