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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103910891
Report Date: 09/24/2021
Date Signed: 09/24/2021 04:09:37 PM

Document Has Been Signed on 09/24/2021 04:09 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:CONTRERAS, ALYSSA FAMILY CHILD CAREFACILITY NUMBER:
103910891
ADMINISTRATOR:CONTRERAS, ALYSSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 265-2335
CITY:FRESNOSTATE: CAZIP CODE:
93737
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 11DATE:
09/24/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Alyssa ContrerasTIME COMPLETED:
04:30 PM
NARRATIVE
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On 09/24/2021 Licensing Program Analyst (LPA) Nancy Her, conducted an unannounced Annual Required Inspection and was met by Licensee Alyssa Contreras. Also present was Licensee’s spouse Arturo Contreras. Days and hours of operation are Monday through Friday 7:00 am to 5:30 pm.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that the kitchen, great room, bathroom 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 spinning door knob covers and locked doors during day care hours. 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, 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) 265-2335.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

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SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Nancy Her
LICENSING EVALUATOR SIGNATURE: DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/24/2021
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 09/24/2021 04:09 PM - It Cannot Be Edited


Created By: Nancy Her On 09/24/2021 at 03:22 PM
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: CONTRERAS, ALYSSA FAMILY CHILD CARE
FACILITY NUMBER: 103910891

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(d)(1)
Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above. During today's inspection, Licensee had an uncleared female adult present and assisting with the children which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 09/24/2021
Plan of Correction
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Licensee immediately had the uncleared female adult leave the premises.
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:Duane Matsubara
LICENSING EVALUATOR NAME:Nancy Her
LICENSING EVALUATOR SIGNATURE:
DATE: 09/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/24/2021


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Document Has Been Signed on 09/24/2021 04:09 PM - It Cannot Be Edited


Created By: Nancy Her On 09/24/2021 at 03:22 PM
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: CONTRERAS, ALYSSA FAMILY CHILD CARE
FACILITY NUMBER: 103910891

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
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 record review, the licensee did not comply with the section cited above. Licensee and spouse did not complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training which was on 9/15/2019 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/25/2021
Plan of Correction
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Licensee and spouse will complete mandated reporter training via www.mandatedreportertrainingca.com and submit certificates of completion to Fresno Community Care Licensing by 10/25/2021.
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. During today's children's record review, LPA observed that all children's files were missing immunization records which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/25/2021
Plan of Correction
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Licensee will have parents/authorized representatives submit current immunization records. Licensee will submit copies of immunization records to Fresno Community Care Licensing by 10/25/2021.
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 Matsubara
LICENSING EVALUATOR NAME:Nancy Her
LICENSING EVALUATOR SIGNATURE:
DATE: 09/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/24/2021


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Document Has Been Signed on 09/24/2021 04:09 PM - It Cannot Be Edited


Created By: Nancy Her On 09/24/2021 at 03:41 PM
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: CONTRERAS, ALYSSA FAMILY CHILD CARE
FACILITY NUMBER: 103910891

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/24/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(D)
The provider shall supervise infants while they are sleeping and adhere to the following requirements:
(D) Documentation shall be maintained in the infant’s file and be available to the Department for review.
Documentation shall include the following:
1. Date.
2. Infant’s name.
3. Time of each 15-minute check.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. During today's inspection, Licensee was not aware she had to complete a safe sleep 15 minute check log for infants therefore she did not have a 15-minute check log which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/25/2021
Plan of Correction
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Licensee will document time of each 15-minute check on a safe sleep 15 minute check log for two weeks for all four of her infants and submit copies to Fresno Community Care licensing by 10/25/2021.
Type B
Section Cited
CCR
102416(c)
The licensee and other personnel as specified, shall complete training on preventive health practices including pediatric CPR and first aid.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above. During today's inspection, upon staff record review, LPA observed that Licensee's pediatric/first aid CPR expired on 03/16/2021 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/25/2021
Plan of Correction
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Licensee will complete pediatric CPR and first aid training and submit verification of completion to Fresno Community Care licensing by 10/25/2021. If Licensee's appointment is after POC due date, Licensee will submti verificaton of appointment.
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 Matsubara
LICENSING EVALUATOR NAME:Nancy Her
LICENSING EVALUATOR SIGNATURE:
DATE: 09/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/24/2021


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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: CONTRERAS, ALYSSA FAMILY CHILD CARE
FACILITY NUMBER: 103910891
VISIT DATE: 09/24/2021
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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 outdoor play area in the backyard is fenced and there are no hazards to children present. There are 3 dogs that are accessible to children. There is an aquarium with fish in the living room. There are 2 tortoises and 3 chickens that are outside and inaccessible to children. There are 3 cats, 2 guinea pigs in a cage and 5 snakes in terrariums that are upstairs and inaccessible to children. Licensee understands the liability of pets around day care children and accepts responsibilities of any action taken by pets. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was completed on 09/15/19. Licensee’s pediatric CPR/First Aid expired on 03/16/21. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

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. Licensee 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, or transfer their existing 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.
Incidental Medical Services (IMS) policy was 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

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.

Continued on 809-C
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Nancy Her
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
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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: CONTRERAS, ALYSSA FAMILY CHILD CARE
FACILITY NUMBER: 103910891
VISIT DATE: 09/24/2021
NARRATIVE
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To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D)

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.

Exit interview conducted and report was reviewed with the facility representative Alyssa Conteras.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Nancy Her
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021
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