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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543909521
Report Date: 11/16/2021
Date Signed: 11/16/2021 02:04:09 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 CAREFACILITY NUMBER:
543909521
ADMINISTRATOR:RODRIGUEZ, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 736-6505
CITY:VISALIASTATE: CAZIP CODE:
93277
CAPACITY:14CENSUS: 6DATE:
11/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Leticia RodriguezTIME COMPLETED:
02:20 PM
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On 11/16/2021, Licensing Program Analyst (LPA), Theresa Marquez, conducted an unannounced Required 1 year inspection. LPA met with Licensee, Leticia Rodriguez and toured the home, and a census was taken. Also present was assistant Rosa Ramos.

The swimming pool is fenced per regulation. There are no firearms or ammunition present in the home. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is made inaccessible to children by use of an iron screen. There is a working fire extinguisher, smoke and carbon monoxide detector, and there is adequate heating and ventilation for safety and comfort. There are no stairs in the home. There is a working telephone. Adequate supervision is being provided during this visit.

Children are supervised when outside in the unfenced play area. Licensee has 1 small dog that is accessible to children. Licensee is aware of child safety around pets and accepts responsibility for any action taken by the petw. Capacity as specified on the license is being maintained. Licensee has a current roster of the children. Fire drills are conducted and documented with the date and time every six months.

Pediatric CPR/First Aid are current and expire 3/17/2023. Immunizations for licensee and assistant was reviewed and verified. Licensee completed the requred Mandated Reporter Training on 3/5/2020.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.



(see next page LIC809-C):
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
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: 11/16/2021
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LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms, and Regulations.

Operating hours are Monday through Friday 7:30 AM to 5:30 PM.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

An exit interview was conducted with Leticia Rodriguez and the facility evaluation report was reviewed. A copy of Appeal Rights and A notice of site visit was given and must remain posted for 30 days.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations no deficiencies are observed today.
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa MarquezTELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2021
LIC809 (FAS) - (06/04)
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