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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543909501
Report Date: 12/05/2019
Date Signed: 12/05/2019 01:45:57 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:GARCIA, MERICIA FAMILY CHILD CAREFACILITY NUMBER:
543909501
ADMINISTRATOR:GARCIA, MERICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 355-5929
CITY:LINDSAYSTATE: CAZIP CODE:
93247
CAPACITY:14CENSUS: 4DATE:
12/05/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Mericia GarciaTIME COMPLETED:
02:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Diane Mercado conducted an unannounced annual inspection. LPA met with Licensee Mericia Garcia. LPA conducted a tour of the home, inside and outside, as shown on the facility sketches (LIC 999A) provided. The rooms accessible to children in care are: living room, bathroom, and front yard. Off-limits rooms are made inaccessible via plastic door knob spinners and locks. Two pets were observed during today’s inspection; licensee is aware of the safety of children around animals. Licensee stated her pets are kept inaccessible from children via off limit rooms. There are no "bodies of water" or firearms in this home. No poisons were observed on the premises. Cleaning compounds, medications and other hazardous items are inaccessible to children. There is no fireplace. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. There are no stairs in the home. There is a working telephone and number was verified. Adequate supervision is being provided during this inspection. Children are supervised when outside in the unfenced play area. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Licensee does maintain documentation of immunizations against pertussis, measles or influenza for herself. Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Licensee was missing immunization records for two of the four children in care. Fire drills are conducted and documented with the date and time every six months. Licensee is aware that children are never to be left in parked vehicles. 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. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Pediatric CPR/First Aid is current and expires 07/13/2021. Mandated Reporter training AB 1207 is current and was completed on 03/06/2018. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and notification of parents’ rights poster are posted on living room wall. Licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address. Days and hours of operation are Monday – Saturday; 4:00 AM – 6:00 PM.

Continued 809-C

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Diane MercadoTELEPHONE: (559) 341-6334
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019
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 3
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: GARCIA, MERICIA FAMILY CHILD CARE
FACILITY NUMBER: 543909501
VISIT DATE: 12/05/2019
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. Licensee is not providing IMS services at this time. Licensee is aware if IMS will be provided an IMS plan is to be submitted to Community Care Licensing office within 30 days. The following information regarding Americans with Disability Act (ADA) was provided: US Department of Justice toll free ADA Information line at (800) 514-0301(voice) and (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm for Commonly Asked Questions about Child Care Centers and the ADA.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINS), Quarterly Updates, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiency is found: (see LIC809-D)


Exit interview was conducted with Licensee Mericia Garcia. Licensee was provided a copy of appeal rights.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Diane MercadoTELEPHONE: (559) 341-6334
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: GARCIA, MERICIA FAMILY CHILD CARE
FACILITY NUMBER: 543909501
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/05/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/06/2020
Section Cited

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Immunizatiosn. The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement was not met, as evidenced by:
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Based on observation and record review during today's inspection, licensee did not provide proof of immunization records for Child #1 & Child #2 . This poses a potential risk to the health, safety or personal rights of children in care.
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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: Diane MercadoTELEPHONE: (559) 341-6334
LICENSING EVALUATOR SIGNATURE:
DATE: 12/05/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/05/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3