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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543909521
Report Date: 06/12/2019
Date Signed: 06/13/2019 11:49:26 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:RODRIGUEZ, LETICIA FAMILY CHILD CAREFACILITY NUMBER:
543909521
ADMINISTRATOR:RODRIGUEZ, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 736-6505
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY:14CENSUS: 12DATE:
06/12/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Leticia RodriguezTIME COMPLETED:
12:00 PM
NARRATIVE
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On this date, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced case management inspection at the facility. LPA met with Licensee, Leticia Rodriguez, to discuss Community Care Licensing (CCL) regulations. LPA Pacheco discussed the purpose of the inspection with Licensee and obtained a census. Based on interviews conducted, it was determined Licensee allowed an adult without a criminal record clearance to help her take care of the day care children.

Per California Code of Regulations, Title 22, Division 12, Chapter 3, the following deficiencies are found:

102370(d)(1) - (d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department.

102370(e) - Violation of Section 102370(d) will result in a citation of a deficiency and an immediate assessment of civil penalties of one hundred ($100) per violation per day for a maximum of five (5) days by the Department.

Any Licensing reports indicating a Type A deficiency shall be posted immediately and for the next 30 days and copies provided of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Health & Safety Section 1596.859(a) shall be cited and a civil penalty of $100.00 for failure to provide copies to parents/guardians of children in care and newly enrolled children, and for failure to maintain written verification of receipt of licensing reports indicating a Type A violation (LIC 9224).

A copy of this report and appeal rights were provided to Licensee.
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2019
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: RODRIGUEZ, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 543909521
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/12/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/12/2019
Section Cited
CCR
102370(d)(1)&(e)
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This requirement was not met as evidenced by Licensee allowing an adult without a criminal record clearance to help her take care of the day care children. This poses an immediate risk to the health, safety, or personal rights of children in care. An immediate civil penalty
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Licensee provided LPA with a written POC at today's inspection. The POC indicated Licensee agreed there was an adult at the day care during day care hours that was not her assistant or fingerprint cleared. Licensee further stated she had not completely hired her yet. Licensee said she has learned her lesson
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of $100.00 is assessed at today's inspection.
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to not have no one with no fingerprints cleared in her day care during operating work hours. Citation cleared at today's inspection.
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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: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2019
LIC809 (FAS) - (06/04)
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