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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911040
Report Date: 09/28/2021
Date Signed: 09/29/2021 09:07:44 AM

Document Has Been Signed on 09/29/2021 09:07 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:O'NEAL, JOHN & PAM FAMILY CHILD CAREFACILITY NUMBER:
103911040
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 1DATE:
09/28/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Pamela O'nealTIME COMPLETED:
12:15 PM
NARRATIVE
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On 09/28/2021 Licensing Program Analyst (LPA) Stefanie Galvan, conducted an unannounced Annual Required Inspection and was met by Licensee, Pamela O’Neal. Days and hours of operation are Monday through Friday 6am to 6pm.

LPA toured the home inside and outside and a census was taken. Current facility sketch was reviewed and Licensee confirmed that the kitchen, dining/eating area, downstairs bathroom, living room and downstairs bedroom are used for providing care and are accessible to children. Formal living room and formal dining room are off-limits. 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 electric fireplace located in the formal living room is made inaccessible and will not be in use during daycare 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 in child accessible living room and downstairs bedroom. The home has working telephone service and LPA confirmed the phone number is (559) 289-0053.

There are currently no infants in care. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping. Cont'd on LIC812-C

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Stefanie Galvan
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2021
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 09/29/2021 09:07 AM - It Cannot Be Edited


Created By: Stefanie Galvan On 09/28/2021 at 10:58 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: O'NEAL, JOHN & PAM FAMILY CHILD CARE
FACILITY NUMBER: 103911040

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(d)
Operation of A Family Child Care Home
(d) The home shall provide safe toys, play equipment and materials.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above; LPA observed backyard items which included a broken swing set, a dry Christmas tree, broken bikes and a dog house. LPA observed a broken iron gate/fence with a plastic table acting as a temporary barrier, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/15/2021
Plan of Correction
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Licensee stated she will have a portion of her backyard fenced so that any hazardous items can be stored and/or removed.
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, her husband and adult daughter who live in home have Mandated Reporter Training certificates that expired on 9/5/2019 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/05/2021
Plan of Correction
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Licensee and associated adults will complete AB1207- Mandated Reporter Training and submit proof to licensing office by POC due date of 10/5/2021.
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:Alice Juarez
LICENSING EVALUATOR NAME:Stefanie Galvan
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2021


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/29/2021 09:07 AM - It Cannot Be Edited


Created By: Stefanie Galvan On 09/28/2021 at 10:58 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: O'NEAL, JOHN & PAM FAMILY CHILD CARE
FACILITY NUMBER: 103911040

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

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 associated adults in home have CPR/First Aid training which expired on 8/26/2019; which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/29/2021
Plan of Correction
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Licensee to provide licensing analyst proof of appointment date for next available class.

During visit, licensee contacted American Red Cross and made an appointment for herself, her husband and adult daughter to attend CPR/First Aid training on 10/23/2021.
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:Alice Juarez
LICENSING EVALUATOR NAME:Stefanie Galvan
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2021


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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: O'NEAL, JOHN & PAM FAMILY CHILD CARE
FACILITY NUMBER: 103911040
VISIT DATE: 09/28/2021
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. Currently licensee provides child pick up in the mornings as well as after school transportation. Licensee is aware that she must follow all laws regarding transportation including, but not limited to keeping her drivers license current and registration for all vehicles used current. The backyard play area was observed to have a swing set with a broken teeter-totter seat. Licensee stated she is ordering a new swing set. LPA observed a dry tree, broken toys and bikes, a dog house and a broken iron gate/fence in the corners of the backyard areas which children may wander into due to them being barricaded by a plastic table that is not secure. Licensee stated she will have portions of her backyard fenced in securely to prevent hazards. 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 has expired on 9/5/2021. Licensee’s pediatric CPR/First Aid expired on 8/26/2021. Licensee made an appointment to renew CPR for herself, husband, and daughter for 10/23/2021. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

Community Care Licensing (CCL) shall notify a Licensee to immediately terminate the employment of, or to remove/bar any person with specified convictions or for other reasons; the Licensee shall comply with the notice. 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.

Continued on 809-C

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Stefanie Galvan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021
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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: O'NEAL, JOHN & PAM FAMILY CHILD CARE
FACILITY NUMBER: 103911040
VISIT DATE: 09/28/2021
NARRATIVE
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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.

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

End of Report

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Stefanie Galvan
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021
LIC809 (FAS) - (06/04)
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