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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910265
Report Date: 01/13/2020
Date Signed: 01/14/2020 10:02:27 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:CORREA, CHERILYN FAMILY CHILD CAREFACILITY NUMBER:
543910265
ADMINISTRATOR:CORREA, CHERILYNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 280-5184
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 6DATE:
01/13/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Cherilyn Correa - Licensee TIME COMPLETED:
02:15 PM
NARRATIVE
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An unannounced Annual/Random Inspection was conducted today by Licensing Program Analyst (LPA) Jessika Thompson. LPA with met with Licensee Cherilyn Correa. Also present was licensee’s assistant, Anna Castanon, and six day-care children. A tour of the facility was made. Background clearances were discussed, and licensee confirmed all adults residing and/or providing care and supervision have a criminal record clearance. Licensee has current pediatric CPR and First Aid that expire on 10/14/21. Accessible areas of the home are the living room, dining room, kitchen, bedroom #1, and hallway bathroom. Off-limit rooms are made inaccessible by spinning door knob covers, which were observed to be in place by LPA on this date. The home is clean and orderly, with heating and ventilation for safety and comfort. There are no stairs in the home. Safe, healthful, and comfortable accommodations, furnishings, toys and equipment were observed. There is a working telephone. A current roster of children in care is maintained. Licensee ensures that children in care are supervised at all times. Fire and disaster drills are conducted at least once every six months, and documented with the date and time. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are stored where they are inaccessible to children. Confirmed firearms are stored in accordance with Title 22 regulations and inaccessible to children. Facility has required fire extinguisher and smoke detector, both meet State Fire Marshall standards. Facility has one functioning carbon monoxide detector that meets statutory requirements. Licensee understands children may not be left in parked vehicles. Safe sleep practices for infants was discussed and LPA provided the licensee with a handout. Lead safety was discussed, and LPA provided Licensee with a brochure. Licensee understands that lead safety information must also be provided to parents and/or authorized representatives of children in care. Provider Information Notices were discussed, and licensee is subscribed to receive updates via email as of today. Licensee is aware that forms and updated information may be obtained on the Department's website, ccld.ca.gov. Licensee is urged to visit the U.S. Consumer Product Safety Commission web page at www.cpsc.gov to ensure that equipment purchased for the day care have not been recalled.

(Continued on LIC809-C)

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

DATE: 01/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2020
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: CORREA, CHERILYN FAMILY CHILD CARE
FACILITY NUMBER: 543910265
VISIT DATE: 01/13/2020
NARRATIVE
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Licensee has completed a certified Child Abuse Mandated Reporter training course. Licensee was advised that this certification must be renewed every two years. Licensee understands that it is her responsibility to stay current with regulations.

Incidental Medical Services (IMS) are not currently being provided. Licensee was advised that if/when any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Licensee was advised that the Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).


Hours of operation are Monday through Friday from 6:45 AM to 5:45 PM and as arranged; less than 24 hours. Licensee is reminded of inspection authority by employees of the Department at any time, with or without advance notice.

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

In exit interview the licensee was advised of appeals rights and was provided with Appeals Rights.

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: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 01/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2020
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: CORREA, CHERILYN FAMILY CHILD CARE
FACILITY NUMBER: 543910265
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/13/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/20/2020
Section Cited

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The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: All licensees shall ensure the inaccessibility of pools, fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence...
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Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use. This requirement was not met, as evidenced by LPAs observations. During today's inspection, LPA observed a covered, empty, unlocked spa located in an inaccessible (fenced off) area of the licensee's backyard. The latches attached to the spa cover were broken, thereby preventing the spa from being locked as required. This poses a potential risk to the health, safety, or personal rights of children in care.
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Type B
01/24/2020
Section Cited

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 Child’s Records. The licensee shall maintain, in each child’s record, the signed and dated notice form, Parents Rights Notice (LIC 995A). This requirement was not met, as during today's inspection, the licensee was unable to provide LIC 995As for two children. This poses a potential risk to the health, safety, or personal rights of children in care.
Type B
01/31/2020
Section Cited

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Immunizations. Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement was not met, as during today's inspection, the licensee was unable to provide immunization records for Child #1. This poses a potential risk to the health, safety, or personal rights of children in care.
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: 01/13/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/13/2020
LIC809 (FAS) - (06/04)
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