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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910535
Report Date: 09/02/2021
Date Signed: 09/02/2021 01:13:54 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:VALDEZ, ANNA FAMILY CHILD CAREFACILITY NUMBER:
543910535
ADMINISTRATOR:VALDEZ, ANNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 740-0579
CITY:VISALIASTATE: CAZIP CODE:
93291
CAPACITY:14CENSUS: 7DATE:
09/02/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Jadelyn Castro - Licensee's AssistantTIME COMPLETED:
01:05 PM
NARRATIVE
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On 9/2/21 Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced Annual Required Inspection. LPA was met by the licensee’ assistant, Jadelyn Castro. Days and hours of operation are Monday through Friday, 7:00AM-5:00PM
LPA toured the home inside and outside and a census was taken. Upon entry, LPA observed Ms. Castro caring for seven children; none of the children present were enrolled in and attending kindergarten, or at least six years of age as required when 7-8 children are present without an additional provider. Licensee’s current facility sketch was reviewed, and Ms. Castro confirmed that the kitchen, bathroom, day-care room, and living room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of baby gates. 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. The fireplace is made inaccessible by a screen and will not be in use during day-care hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Stairs are fenced or barricaded when children under age 5 years old are present. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559) 740-0579.

Infants are not swaddled while in care. Provider was unable to provide proof that staff physically checks on sleeping infants every fifteen minutes during records review. LPA advised Ms. Castro that staff must document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature and restlessness on a sleep log. Infants can be visually observed through an open door if sleeping in a separate room. Provider understands that infants up to 12 months of age should be 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 (see next page, LIC809C).
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021
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: VALDEZ, ANNA FAMILY CHILD CARE
FACILITY NUMBER: 543910535
VISIT DATE: 09/02/2021
NARRATIVE
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LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Ms. Castro was unable to provide proof of completion of Child Abuse Mandated Reporter Training for herself or the Licensee. Ms. Castro’s pediatric CPR/First Aid expires on 8/24/21.

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.



LPA and Ms. 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.

Upon receipt of a Type A violation, licensee shall post and provide copies 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. A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 was given to licensee.

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

DATE: 09/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021
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: VALDEZ, ANNA FAMILY CHILD CARE
FACILITY NUMBER: 543910535
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/02/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/16/2021
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 school
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and a second child is at least six years of age. This requirement was not met as evidenced by LPA's observations(see LIC809 for further details). This poses an immediate risk to the health, safety, or personal 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: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 09/02/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/02/2021
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: VALDEZ, ANNA FAMILY CHILD CARE
FACILITY NUMBER: 543910535
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/02/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2021
Section Cited

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training...and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement was not met, as during today's inspection,
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Ms. Castro were unable to provide proof of current Child Abuse Mandated Reporter training completion for herself & the licensee. This poses a potential risk to the health, safety, or personal rights of children in care.
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Type B
09/16/2021
Section Cited

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The provider shall supervise infants while they are sleeping and adhere to the following requirements:The provider shall physically check on the infant every 15 minutes...This requirement was not met as evidenced by records review. See LIC809 for further details.
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This poses a potential 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: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 09/02/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/02/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4