543911572-11-1-2021-04-CC-RMAS-C8CN5E-20211101100924

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543911572
Report Date: 11/01/2021
Date Signed: 11/01/2021 10:09:31 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:	REYES, ANNA FAMILY CHILD CARE		FACILITY NUMBER:	543911572
ADMINISTRATOR:	REYES, ANNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 306-9787
CITY:	PORTERVILLE	STATE: CA	ZIP CODE:	93257
CAPACITY:	14	CENSUS: 0	DATE:	11/01/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Anna Reyes		TIME COMPLETED:	10:15 AM

NARRATIVE

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On 11/01/2021 a planned Pre-licensing inspection was made today by Licensing Program Analyst (LPA) Rene Mancinas, who met with Applicant, Anna Reyes. A tour of the home, inside and outside, as shown on the facility sketch was done. This is a single-story home. The areas of the home that day-care children will have access to are the living room, dining room, kitchen, children’s restroom, two bedrooms, and the backyard. The remainder of the home is off limits and made inaccessible by means of child safety devices. Applicant is the only adult that resides in the home. The LIS 536 was signed indicating that the adults living in the home and/or providing care and supervision to children are background cleared. LPA observed safe toys, safe indoor play areas, child safety plugs in unused electrical outlets, child safety latches on cabinets and/or cabinets with safe items, were all observed. Fire extinguisher, smoke detectors, carbon monoxide detectors and first aid kit are operable and in place. There are no firearms or ammunition present at this home. There is no in-ground swimming pool or other bodies of water at this home. CPR, first aid training, and health and safety training are current and expiring 05/20/2023. Child Abuse Mandated Reporter Training Completed on 01/15/2020. Postings, forms, and licensing information were provided and discussed. LPA discussed the practice of fire and disaster drills at least every 6 months and to document the date, time and number of children present. There are no pets at this home.

Incidental Medical Services (IMS) policy were 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

(Continued on 809-C)

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2021

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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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: REYES, ANNA FAMILY CHILD CARE	FACILITY NUMBER: 543911572
	VISIT DATE: 11/01/2021

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Applicant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed applicants of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The home has been given fire clearance by the Fire Department with jurisdiction to the facility, and has forwarded documentation to CCL.

Before Licensure the following items are to be corrected within 30 days to avoid the application form being withdrawn:

1. Applicant needs to correct outdoor fencing issues. During today’s inspection, LPA observed 5 wood fencing panels that were loose or falling off, creating a space large enough for a child to push through and enter the neighbor's backyard.

Pending verification of corrections and a final review of your application, licensure as a Large Family Child Care Home capacity of 14 children* ages under 18 years, will be recommended. Planned hours of operation are 24/7, with applicant understanding she cannot care for a child for a continuous 24 hours.

Exit interview conducted and report was reviewed with the applicant.
This report shall be made available to the public upon request.
To order forms, etc. visit our website at www.ccld.ca.gov

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Rene Mancinas	TELEPHONE: (559) 341-4524
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2021

LIC809 (FAS) - (06/04)

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