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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543911296
Report Date: 11/30/2021
Date Signed: 11/30/2021 12:50:45 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:GARCIA, DELIA FAMILY CHILD CAREFACILITY NUMBER:
543911296
ADMINISTRATOR:GARCIA, DELIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 789-0900
CITY:POPLARSTATE: CAZIP CODE:
93258
CAPACITY:14CENSUS: 6DATE:
11/30/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Licensee, Delia GarciaTIME COMPLETED:
01:15 PM
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On 11/30/21, Licensing Program Analyst (LPA), Jose Penate, conducted an unannounced Annual Required Inspection and was met by Licensee, Delia Garcia (SPANISH speaking) also present was Assistant, Alejandra Garcia. Planned hours of operation are Monday through Saturday from 4:00AM - 6:00PM and as arranged.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed, and the areas of the home that day care children will have access to are the Daycare room (garage the was converted), bathroom and backyard. All other rooms are off-limits and made inaccessible child safety locks. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition at this home. No poisons were observed during the inspection.

There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. The home has working telephone service and LPA confirmed the phone number is 559-789-0900.

There was 1 infant in care, LPA discussed infant under the age of 12 months must sleep in cribs and play yards and will be kept free from all loose articles and objects while infants are sleeping. LPA discussed with provider on physically checking 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. Licensee stated that she was unaware of documenting sleeping checks for infants in care. Infants shall not be swaddled while in care. LPA discussed Individual Infant Sleeping Plan for infants up to 12 months of age. Infants up to 12 months of age will be placed on their backs for sleeping.

Continued on LIC 809-C

SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2021
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: GARCIA, DELIA FAMILY CHILD CARE
FACILITY NUMBER: 543911296
VISIT DATE: 11/30/2021
NARRATIVE
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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 back yard play area is fenced and there are no hazards to children present, licensee ensures visual supervision is made while children are at outdoor play. Capacity as specified on the license is being maintained.

Licensee has a current roster of the children. An emergency fire/disaster drill has been completed and documented within the last 6 months. Licensee’s pediatric CPR/First Aid is current and will expire 8/30/2023. Mandated Reporter has not been completed for licensee and staff, both are currently expired .

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 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, deficiencies cited (See 809-D).

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: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2021
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: GARCIA, DELIA FAMILY CHILD CARE
FACILITY NUMBER: 543911296
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/30/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
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 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 by documenting the observation of sleeping infants while in care, this poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/30/2021
Plan of Correction
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Licensee stated that as of today she will begin documenting observations of all infants under 24 months of age while in care.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), 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 is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee and assistant did not comply with the section cited above in by not completing training within the last 2 years. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/17/2021
Plan of Correction
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Licensee stated that herself and assistant will complete mandated reporter training by POC date.
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: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Jose PenateTELEPHONE: (559) 341-5860
LICENSING EVALUATOR SIGNATURE:
DATE: 11/30/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/30/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4