543909517-6-20-2019-04-CC-PESA-BD8TYD-20190617150834

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543909517
Report Date: 06/17/2019
Date Signed: 06/20/2019 07:45:14 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:	NAVARRO, TERESA FAMILY CHILD CARE		FACILITY NUMBER:	543909517
ADMINISTRATOR:	NAVARRO, TERESA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 302-7800
CITY:	VISALIA	STATE: CA	ZIP CODE:	93292
CAPACITY:	14	CENSUS: 4	DATE:	06/17/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Micaela Curiel, Assistant		TIME COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	(3) LPA Pete Espinoza made an unannounced Annual/Random inspection. LPA met with Micaela Curiel, Assistant (Spanish Speaking), who provided a tour of the home, inside and outside, as shown on the facility sketch. There are no "bodies of water" or firearms in this facility. Storage areas for poisons, detergents, cleaning compounds, medications and other items which could pose a danger to children are stored where they are inaccessible to children; and poisons are locked. There is no fireplace. Fire extinguishers and smoke/carbon monoxide detectors meet State Fire Marshall standards. The home is kept clean and orderly, with heating and ventilation for safety and comfort. Where children less than five years old are in care, stairs are fenced or barricaded. The home provides safe toys, play equipment, and materials. When temporarily absent from the home, the licensee arranges for a substitute adult to care for and supervise children in her/his absence. Each child has safe, healthful, and comfortable accommodations, furnishings, and equipment. The home conducts fire and disaster drills at least once every six months, and documents the date and time of each drill. All individuals subject to a criminal record review have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home. The licensee and other personnel as specified have completed training on preventive health practices including pediatric CPR and First Aid. Business hours are Mon-Fri 6:00 AM to 6:00 PM and other hours as arranged. 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. The following is cited per chapter 3, Title 22, Div. 12 of the CCR: (see page 2) Copy of appeal Rights left with center representative/licensee. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

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 5

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: NAVARRO, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 543909517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/17/2019

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416.3(a)

Facility Administration - Alterations to Existing Building or Grounds

(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:
	Deficient Practice Statement
1 2 3 4	Inspection Tool Notes: Licensee failed to report new room/patio addition to Fresno Regional Office prior to completion.
	POC Due Date: 07/17/2019
	Plan of Correction
1 2 3 4	Licensee will send to Fresno Regional Office updated Facility Sketch indicating rooms used by day-care. An Inspection/review of room addition will be required prior to use for caring of children.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

LIC809 (FAS) - (06/04)

Page: 5 of 5

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: NAVARRO, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 543909517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/17/2019

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(10)

Physical Plant - 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: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).
	Deficient Practice Statement
1 2 3 4	Inspection Tool Notes: LPA Observed child sleeping in bouncer.
	POC Due Date: 06/17/2019
	Plan of Correction
1 2 3 4	Assistant removed bouncer from child care area during visit. Deficiency cleared during visit.

Type B

Section Cited

HSC

1596.8662(b)(1)

Facility Administration - 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.
	Deficient Practice Statement
1 2 3 4	Inspection Tool Notes: Assistant is unable to provide proof of required immunizations for all staff.
	POC Due Date: 07/17/2019
	Plan of Correction
1 2 3 4	Licensee will send to Fresno Regional Office proof of completion of Mandated Reporter Training for all staff.

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 deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: NAVARRO, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 543909517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/17/2019

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

Records - Family Day Care Homes

(1)Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
	Deficient Practice Statement
1 2 3 4	Inspection Tool Notes: Assistant is unable to provide proof of immunizations for review
	POC Due Date: 07/17/2019
	Plan of Correction
1 2 3 4	Licensee will send proof of immunizations for all staff to Fresno Regional Office by 07/17/2019.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: NAVARRO, TERESA FAMILY CHILD CARE	FACILITY NUMBER: 543909517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/17/2019

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(g)

Records - Immunizations

(g) 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.
	Deficient Practice Statement
1 2 3 4	Inspection Tool Notes: A review of children's records indicates Child #1 has no immunizations on file.
	POC Due Date: 07/17/2019
	Plan of Correction
1 2 3 4	Licensee will send to Fresno Regional Office copy of immunizations for Child #1 by 07/17/2019.

Type B

Section Cited

CCR

102417(g)(8)

Records - Operation of A Family Child Care Home

(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
	Deficient Practice Statement
1 2 3 4	Inspection Tool Notes: Assistant is unable to provide updated Facility Roster for review
	POC Due Date: 07/17/2019
	Plan of Correction
1 2 3 4	Licensee will send to Fresno Regional Office copy of updated Facility Roster by 07/17/2019.

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 deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2019

LIC809 (FAS) - (06/04)

Page: 3 of 5