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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103903654
Report Date: 12/06/2021
Date Signed: 12/06/2021 11:26:20 AM

Document Has Been Signed on 12/06/2021 11:26 AM - It Cannot Be Edited

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:ALCANTARA, ESMERALDA FAMILY CHILD CAREFACILITY NUMBER:
103903654
ADMINISTRATOR:ALCANTARA, ESMERALDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 896-1670
CITY:SELMASTATE: CAZIP CODE:
93662
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 4DATE:
12/06/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Esmeralda AlcantaraTIME COMPLETED:
12:00 PM
NARRATIVE
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On 12/06/2021 Licensing Program Analyst (LPA), Diane Mercado, conducted an unannounced case management inspection. LPA met with Licensee, Esmeralda Alcantara. Also present was Staff #1. LPA toured the home inside and outside and a census was taken. The purpose of today's inspection was to inspect the accessibility of the in-ground pool in the backyard.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights. Notice of Site Inspection to be posted for 30 days.

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.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Diane Mercado
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2021
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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Document Has Been Signed on 12/06/2021 11:26 AM - It Cannot Be Edited


Created By: Diane Mercado On 12/06/2021 at 10:30 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ALCANTARA, ESMERALDA FAMILY CHILD CARE
FACILITY NUMBER: 103903654

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/06/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/06/2021
Section Cited
CCR
102417(g)(5)

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(5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. This requirement is not met as evidenced by:
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Licensee requested to go on inactive status effective 12/07/2021 and will not provide daycare services until pool is made inaccessible either by pool fencing or an approved pool cover.

A civil penalty will be assed today.
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LPA Mercado observed in the backyard an in-ground pool that is made accessible to day care children through the livingroom sliding glass door with no pool fencing making pool accessible to day care children which poses an immediate health, safety or personal rights risk to persons 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:Susie Fanning
LICENSING EVALUATOR NAME:Diane Mercado
LICENSING EVALUATOR SIGNATURE:
DATE: 12/06/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/06/2021


LIC809 (FAS) - (06/04)
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