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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910471
Report Date: 08/29/2019
Date Signed: 08/29/2019 04:20:25 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:POMPA-NAVARRO, MARCELINA FAMILY CHILD CAREFACILITY NUMBER:
543910471
ADMINISTRATOR:POMPA-NAVARRO, MARCELINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 791-5445
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY:14CENSUS: 5DATE:
08/29/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Marcelina Pompa-Navarro, LicenseeTIME COMPLETED:
01:00 PM
NARRATIVE
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(3) LPA Pete Espinoza made an unannounced Annual/Random inspection. LPA met with Marcelina Pompa-Navarro, Licensee, who provided a tour of the home, inside and outside, as shown on the facility sketch. There are no "bodies of water" or firearms in this facility. Storage areas for poisons, detergents, cleaning compounds, medications and other items which could pose a danger to children are stored where they are inaccessible to children; and poisons are locked. There is no fireplace. Fire extinguishers and smoke/carbon monoxide detectors meet State Fire Marshall standards. The home is kept clean and orderly, with heating and ventilation for safety and comfort. There are no stairs in the home. The home provides safe toys, play equipment, and materials. The licensee is present in the home and ensures that children in care are supervised at all times. Children are not left in parked vehicles. When temporarily absent from the home, the licensee arranges for a substitute adult to care for and supervise children in her/his absence. Each child has safe, healthful, and comfortable accommodations, furnishings, and equipment. The home has a current roster of the children. The home conducts fire and disaster drills at least once every six months, and documents the date and time of each drill. Licensee documents immunizations and maintains and updates records for children in care. All individuals subject to a criminal record review have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home. The licensee and other personnel as specified have completed training on preventive health practices including pediatric CPR and First Aid; Expires: 02/23/2021

Business hours are Mon-Fri 5:30 AM to 6:00 PM.

Licensee provided proof of required immunization (Pertussis/Measles/influenza and/or written declaration declining flu shot) AND required Mandated Reporter Training.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019
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 4
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: POMPA-NAVARRO, MARCELINA FAMILY CHILD CARE
FACILITY NUMBER: 543910471
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/11/2019
Section Cited

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Operation of a Family Child Care Home - Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement is not met as evidenced by records review conducted during today’s inspection.
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Licensee was unable to provide updated Facility Roster.
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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: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: POMPA-NAVARRO, MARCELINA FAMILY CHILD CARE
FACILITY NUMBER: 543910471
VISIT DATE: 08/29/2019
NARRATIVE
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NOT Providing IMS:
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

The following is cited per Title 22 Div. 12 of the CCR: (see page 2) Copy of appeal Rights left with center representative/licensee.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
Notes:* 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).

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: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: POMPA-NAVARRO, MARCELINA FAMILY CHILD CARE
FACILITY NUMBER: 543910471
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/29/2019
Section Cited

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Staffing Ratio and Capacity - For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time shall be six children, no more than three of whom may be infants.
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This requirement is not met as evidenced by observation conducted during today’s inspection. Upon arrival, LPA observed four (4) infants present in the facility. This poses an immediate risk to the health, safety or personal rights of children in care.
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Type A
08/29/2019
Section Cited

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Personal Rights - Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
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This requirement is not met as evidenced by observation conducted during today’s inspection. Upon arrival, LPA observed infant child sleeping in stroller by front door. This poses an immediate risk to the health, safety or personal rights of children in care.
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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: Peter EspinozaTELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:
DATE: 08/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/29/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4