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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911487
Report Date: 08/13/2021
Date Signed: 08/13/2021 01:48:47 PM

Document Has Been Signed on 08/13/2021 01:48 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:NARANJO, CAROLINA FAMILY CHILD CAREFACILITY NUMBER:
103911487
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/13/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Carolina NaranjoTIME COMPLETED:
02:00 PM
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Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On August 13, 2021, Licensing Program Analyst (LPA), Norma Lomeli met with Spanish-Speaking Applicant, Carolina Naranjo for a pre-licensing inspection. Applicant, her husband, her adult daughter and two minor children reside in the home. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • This is a two story, five bedrooms and three and a half bathrooms home and upstairs area will be off-limits to the day-care children. There is a gate at the bottom of the stairs making upstairs area inaccessible. Care and supervision will be provided in the living room (day care room), family room, dining room, kitchen, downstairs bedroom and downstairs half bathroom. There is a full bathroom downstairs that will be inaccessible to the day care children.
  • There is a fireplace in the living room (day care room), and one in the family room that applicant states it will not be used during day-care hours.
  • LPA observed in the day care room; child size furniture, safe toys and books for the day care children. There are arts and crafts supplies and manipulatives toys. Children will nap in the day care room on mats. Infants will nap in play yards. Applicant understands she is to supervise children at all times.
  • Facility has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/13/2021
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: NARANJO, CAROLINA FAMILY CHILD CARE
FACILITY NUMBER: 103911487
VISIT DATE: 08/13/2021
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  • Applicant’s Pediatric CPR and First Aid certification was completed through Pediatric Plus with Emergency Medical Services Authority stickers (EMSA) and expires on June 13, 2023.
  • Preventative Health and Safety including Prevention of Lead Exposure class was completed on April 17, 2021.
  • Knives and medications are stored inside top kitchen cabinets. Cleaning compounds are stored inside the inaccessible garage inside a storage cabinet.
  • Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
  • Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
  • There is an in-ground pool that is fenced with rod iron fencing in accordance with Title 22 Regulations. There are three gates that are self-latching/self-closing and swing away from the pool. LPA observed that there are no windows from the home accessible to the in-ground pool.
  • There are three cats; two cats are kept inside and one is kept outdoor. The cats will be accessible to the day care children. There are two dogs that are kept outdoors in an area inaccessible to the day care children. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
  • Applicant states there are no firearms or ammunition in the home or premises. Poisons are stored inside a storage cabinet that is located in the garage. The poisons are not under key lock.
  • Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
  • Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
  • Applicant states that she will be transporting day care children. Applicant understands that she must have proper restraints and/or car seats for all the children under her care when transporting children.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021
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: NARANJO, CAROLINA FAMILY CHILD CARE
FACILITY NUMBER: 103911487
VISIT DATE: 08/13/2021
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  • Fenced backyard has an area designated to the day care children. There is an artificial grassed area for the day care children. LPA observed tricycles and other safe toys. The day care children will be walked through the accessible downstairs bedroom to go out to the backyard play area. The children will also have access to the side fenced patio that has an exit from the home. LPA observed children size table and chairs. There is a empty Little Tikes sand table. LPA also observed an empty water fountain. There are patio umbrellas for shade.
  • SB 792 immunizations verified and on file.
  • Applicant completed the Mandated Reporter Training on July 10, 2021.
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
  • 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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. She is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday from 7:00 AM to 5:30 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.



(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021
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: NARANJO, CAROLINA FAMILY CHILD CARE
FACILITY NUMBER: 103911487
VISIT DATE: 08/13/2021
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Applicant is advised the following items must be corrected and documentation be sent to CCL within the next 30 days to avoid possible withdraw.
  • Applicant will store all poisons under key lock.

Pending verification of correction of the above item and a final review of her application, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4