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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543909572
Report Date: 08/26/2019
Date Signed: 08/26/2019 03:47:23 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:GONZALEZ, STEPHANIE FAMILY CHILD CAREFACILITY NUMBER:
543909572
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 8DATE:
08/26/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Stephanie Gonzalez - Licensee TIME COMPLETED:
04:05 PM
NARRATIVE
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    On this date, Licensing Program Analyst (LPA) Jessika Thompson conducted a Case Management inspection. LPA met with Licensee Stephanie Gonzalez. A tour of the facility was made and a census was taken. The purpose of this visit was to address two deficiencies discovered during an investigative inspection.
During today's inspection, LPA initially observed there to be six children present; this census was confirmed by the licensee. Upon LPA inspecting other areas of the home, LPA observed there to be two additional children, Child #1 and Child #2, in the licensee's off-limit master bedroom. The licensee stated the children were sick, so she placed them in her bedroom to wait for a parent to pick them up. Licensee confirmed that neither Child #1 or Child #2 are enrolled in and attending kindergarten or elementary school, or at least six years of age, as required by Title 22 regulation.
    In exit interview the licensee was advised of appeals rights and was provided with Appeals Rights. Licensee was also advised that this report with Type A Deficiencies must be posted for 30 days where parents may easily view and filed in facility file for public review for 3 years.

    Licensee is advised to make this licensing report accessible to the public and to provide copies of this licensing report and 809D with Type A citation to parents/legal guardians of children in care and to parents/legal guardians of children newly enrolled at the facility during the next 12 months. An LIC9224 and Assembly Bill 633 fact sheet was provided to licensee on this date.

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

    LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS

    (Continued on LIC809-C)

    SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
    LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
    LICENSING EVALUATOR SIGNATURE:

    		DATE: 08/26/2019
    I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
    FACILITY REPRESENTATIVE SIGNATURE:

    		DATE: 08/26/2019
    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: GONZALEZ, STEPHANIE FAMILY CHILD CARE
    FACILITY NUMBER: 543909572
    DEFICIENCY INFORMATION FOR THIS PAGE:
    VISIT DATE: 08/26/2019
    Deficiency Type
    POC Due Date /
    Section Number
    DEFICIENCIES
    PLAN OF CORRECTIONS(POCs)
    Type B
    08/26/2019
    Section Cited

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    		Alterations to Existing Buildings or Grounds. Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changes, including, but not limited to, the following: Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care. This requirement was not met, as evidenced by inspection conducted by LPA. On this date, LPA observed two children lying on the bed in the licensee's "off limit" bedroom.
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    		The licensee stated she was trying to keep the children away from other day-care children because they were sick. This poses a potential risk to the Health and Safety of children in care.
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    		Deficiency cleared at visit.

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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: Jessika ThompsonTELEPHONE: 559-341-4622
    LICENSING EVALUATOR SIGNATURE:
    		DATE: 08/26/2019
    I acknowledge receipt of this form and understand my appeal rights as explained and received.
    FACILITY REPRESENTATIVE SIGNATURE:
    		DATE: 08/26/2019
    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: GONZALEZ, STEPHANIE FAMILY CHILD CARE
    FACILITY NUMBER: 543909572
    DEFICIENCY INFORMATION FOR THIS PAGE:
    VISIT DATE: 08/26/2019
    Deficiency Type
    POC Due Date /
    Section Number
    DEFICIENCIES
    PLAN OF CORRECTIONS(POCs)
    Type B
    08/30/2019
    Section Cited

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    		A small family day care home may provide care for more than six and up to eight children, without an additional adult attendant, if all of the following conditions are met: (a) At least one child is enrolled in and attending kindergarten or elementary
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    		 school and a second child is at least six years of age. This requirement was not met, as evidenced by LPA's observations. Today, LPA observed the licensee caring for eight children, all of whom were between the ages of one and four. This poses and immediate risk to the health, safety, or personal rights of children in care.
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    		Deficiency cleared at visit.

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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: Jessika ThompsonTELEPHONE: 559-341-4622
    LICENSING EVALUATOR SIGNATURE:
    		DATE: 08/26/2019
    I acknowledge receipt of this form and understand my appeal rights as explained and received.
    FACILITY REPRESENTATIVE SIGNATURE:
    		DATE: 08/26/2019
    LIC809 (FAS) - (06/04)
    Page: 3 of 3