543909521-11-26-2019-04-CC-TMAZ-BJARWH-20191126122311

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543909521
Report Date: 11/26/2019
Date Signed: 11/26/2019 12:23:17 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:	RODRIGUEZ, LETICIA FAMILY CHILD CARE		FACILITY NUMBER:	543909521
ADMINISTRATOR:	RODRIGUEZ, LETICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 736-6505
CITY:	VISALIA	STATE: CA	ZIP CODE:	93277
CAPACITY:	14	CENSUS: 7	DATE:	11/26/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Leticia Rodriguez		TIME COMPLETED:	12:30 PM

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On this date, Licensing Program Analyst (LPA), Theresa Marquez, conducted an unannounced annual inspection and was met by Licensee, Leticia Rodriguez. Also present was her Assistant Rosa Ramos. LPA toured the home inside and outside and a census was taken. Licensee has a working telephone and the above telephone number was verified.

Postings such as Emergency Disaster Plan, Earthquake preparedness checklist, facility license and Notification of Parents Rights poster are posted on the TV room wall.

Licensee confirmed that the TV room, the play room, kitchen/dining area, hall bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of door knob spinners. Safe toys and play equipment are observed. There are no stairs in this home. The fireplace located in the family room is made inaccessible and will not be in use during daycare hours. There is working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort.

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

The outdoor play area in the backyard is fenced and there are no hazards to children present. Swimming pool is fenced per regulation. 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. Licensee has 1 small dog that is accessible to children. Licensee understands the liability and safety of children around pets and accepts responsibility.

Capacity as specified on the license is being maintained. Licensee’s pediatric CPR/First Aid expires on 3/16/2021. Mandated Reported Training was completed on 3/30/2018. An emergency fire/disaster drill has been completed within the last 6 months.

Hours of operation are Monday-Friday, 7:30 AM to 5:30 PM.

Continued LIC809-C

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 11/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019

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
	VISIT DATE: 11/26/2019

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A review of records indicates that immunization records are in file for children and adults. Licensee has a current roster of the children and maintains emergency information and forms as required. Adequate supervision is being provided during this visit. 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.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide these services.

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 Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

This report shall be made available to the public upon request.

LIC 9213 Notice of Site Inspection is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 11/26/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2019

LIC809 (FAS) - (06/04)

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