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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910471
Report Date: 06/14/2022
Date Signed: 06/14/2022 01:03:40 PM


Document Has Been Signed on 06/14/2022 01:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 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: 7DATE:
06/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Marcelina Pompa-NavarroTIME COMPLETED:
01:20 PM
NARRATIVE
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On 6/14/2022, Licensing Program Analyst (LPA), Ruby Ocegueda conducted an unannounced Annual Required Inspection and was met by Licensee, Marcelina Pompa-Navarro. Also present was Staff #2 (S1). Licensee is Spanish Speaking and LPA Ocegueda assisted with interpretation. Days and hours of operation are Monday-Saturday from 5:00 AM – 10:00 PM.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that the bathroom, living room and bedroom #1 are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of chain lock. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There are no fireplaces or open face heaters in the home. There is a working fire extinguisher and carbon monoxide detector and adequate heating and ventilation for safety and comfort. The smoke alarms in the home were tested and were not functioning. Licensee stated that she had not placed batteries in the smoke alarm as of recently and suspected they needed new batteries. There are no stairs in this home. Toys and equipment were inspected and LPA observed that the toy houses were dusty and several dirt smudges. There were two Cosco brand high chairs outside that were dirty and had no straps. Licensee stated the high chairs were outside due to them not being used any longer. One of the tricycles did not have plastic handles. A teeter-totter style toy had broken handles, creating a sharp edge. Licensee removed the highchairs, the tricycle and the teeter-totter and stated she would clean and disinfect the play houses outside. The home has working telephone service and LPA confirmed the phone number is 559-791-5445.

Report continued to 809-C

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2022
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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Document Has Been Signed on 06/14/2022 01:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 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: 06/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(d)
Operation of A Family Child Care Home
(d) The home shall provide safe toys, play equipment and materials.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above. Licensing Program Analyst (LPA) observed the following outside: two dirty cosco brand highchairs that had no straps, a broken teeter-totter toy with broken handle and sharp plastic edges, a tricycle that had no plastic handles, and dusty/dirty play house structures. Licensee confirmed these observations. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/28/2022
Plan of Correction
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Today, 6/14/2022, Licensee removed the teeter-totter, the highchairs, and tricycle and placed them in an off-limits area of the play yard. Licensee stated she would be cleaning and disinfecting the child size playhouses. Proof will be submitted to the Department by POC date 6//28/2022.
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above. Licensing Program Analyst (LPA) tested a total of four smoke detectors and all made only a faint beeping sound when tested. Licensee stated she had not placed batteries in them within the last year and suspected the alarms needed batteries.This which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/28/2022
Plan of Correction
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Licensee stated she would be purchasing the batteries and ensure her smoke detector was working at all times. Proof will be submitted by POC date 6/28/2022.

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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/14/2022 01:03 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 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: 06/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. Licensee could not provide documentation of required measles immunizations. Staff #2 did not have proof of measles and pertussis (MMR/Tdap) immunizations. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/28/2022
Plan of Correction
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Licensee stated he would be placing a copy of required immunizations (MMR/Tdap) in her and S2 files and submit proof to the Department by POC date: 6/28/2022.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: POMPA-NAVARRO, MARCELINA FAMILY CHILD CARE
FACILITY NUMBER: 543910471
VISIT DATE: 06/14/2022
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LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. LPA discussed the requirement to physically check on sleeping infants every fifteen minutes and to document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan was reviewed and discussed with licensee. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed that one of the 7 children present today did not have emergency information as required. LPA discussed this observation and reviewed all forms that should be placed in children’s files. Licensee’s Mandated Reporter Training was completed on 6/3/2021. Licensee’s pediatric CPR/First Aid expires on 2/17/2022. A review of records was conducted for licensee and S2. In licensees file, it was observed that she was missing her proof of measles vaccine. Licensee submitted proof to the Department, however it was not available today for review. S2 did not have proof of pertussis, measles or influenza. Licensee confirmed this observation.

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 any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.


Report continued to 809-C
SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: POMPA-NAVARRO, MARCELINA FAMILY CHILD CARE
FACILITY NUMBER: 543910471
VISIT DATE: 06/14/2022
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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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Susie FanningTELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Ruby OceguedaTELEPHONE: (559) 341-5808
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2022
LIC809 (FAS) - (06/04)
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