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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103911678
Report Date: 12/20/2023
Date Signed: 12/20/2023 12:04:46 PM

Document Has Been Signed on 12/20/2023 12:04 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:SAUCEDA, SANDRA FAMILY CHILD CAREFACILITY NUMBER:
103911678
ADMINISTRATOR:SAUCEDA, SANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 612-5775
CITY:FRESNOSTATE: CAZIP CODE:
93703
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
12/20/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Evelyn SaucedaTIME COMPLETED:
12:45 PM
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On 12/20/2023 Licensing Program Analyst (LPA), Pa Kou Vue conducted an unannounced Annual Required Inspection and was met by Staff 2 and Staff 3. Also present was licensee’s adult daughter. Staff members stated Licensee has been out of town, 12/17/2023 - 12/24/2023. Staff members were reminded of CCR 102417(a) regulation.

The home has working telephone service and LPA confirmed the phone number is (559) 612-5775.

Days and hours of operation are Monday to Friday, 7:00AM – 5:30PM.

LPA toured the home inside and outside and a census was taken and there were 1 infant and 4 children in care. Capacity as specified on the license is being maintained.

This is a single level home and there are no stairs. LPA reviewed current facility sketch (LIC 999A) and Licensee confirmed that the bathroom, daycare room and backyard are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of doorknob spinners.

There is a built-in swimming pool in the backyard. LPA observed in backyard an in-ground pool. In accessible day-care room, LPA two French doors that led into the backyard. A small portion of the backyard has a built-in wooden plank fence that obscures the view of the pool. LPA observed on the exterior of the backyard, there are windows located the living room, 2nd bedroom and 3rd bedroom that has direct access to the backyard and pool. LPA observed two wooden plank door fences install on either side of the home that prevents direct access to the backyard and pool.

Staff 3 stated, there are no firearms or ammunition stored on the premise.

Staff 3 stated there are no poisons stored on the premise.

Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There is one fireplace in the home located in the day-care room and is made inaccessible and will not be in use during daycare hours.

(Continued on 809-C).

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Pa Kou Vue
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2023
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 5
Document Has Been Signed on 12/20/2023 12:04 PM - It Cannot Be Edited


Created By: Pa Kou Vue On 12/20/2023 at 11:22 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: SAUCEDA, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 103911678

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(5)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (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. (A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observations, Licensee and staff 3 interview, LPA observed on the exterior of the backyard, there are windows located the living room, 2nd bedroom and 3rd bedroom that has direct access to the backyard and pool. In addition, LPA observed two wooden plank door fences install on either side of the home that prevents direct access to the backyard and pool. The licensee did not comply with the section cited above in out of which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/05/2024
Plan of Correction
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Licensee stated she will submit receipt copies of fence purchasings to LPA via email. Licensee stated she will inform LPA of fence installation surrounding the pool and 3 windows that have direct access to the backyard/pool. In addition, the removal of the wooden plank fence. LPA will conduct a POC to verify the above meets Child Care Licensings regulations.

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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/20/2023 12:04 PM - It Cannot Be Edited


Created By: Pa Kou Vue On 12/20/2023 at 11:22 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: SAUCEDA, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 103911678

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(a)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA records review, staff 2 is missing MMR and staff 3 is missing LIC9052 and Mandated Reporter Training. The licensee did not comply with the section cited above in out of which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/05/2024
Plan of Correction
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Staff members stated copies of the requested documents will be submitted to LPA via email by end of workday 01/05/2024.
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA records review and staff 3 interview, child 1 is missing LIC9227 and 15-minute sleep logs. The licensee did not comply with the section cited above in out of which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/05/2024
Plan of Correction
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Staff members stated copies of the requested documents will be submitted to LPA via email by end of workday 01/05/2024.
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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2023


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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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: SAUCEDA, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 103911678
VISIT DATE: 12/20/2023
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There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort.

Staff 3 ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. The outdoor play area in the backyard is fenced and there are no hazards to children present. Safe toys and play equipment are observed. LPA observed in living room 2 cribs stored inside were children's play mats, infant play structures and a loose blanket. Staffs were reminded cribs are to be free of loose articles and objects. Staff members stated they understood.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Based upon LPA records review and staff 3 interview, child 1 is missing LIC9227 and 15-minute sleep logs. Licensee’s Mandated Reporter Training expires on 05/25/2025. Licensee’s pediatric CPR/First Aid certification expires on 08/27/2024. A review of records indicates that all employees and/or volunteers does not have immunization records on file for influenza, pertussis, and measles. Based upon LPA records review, staff 2 is missing MMR and staff 3 is missing LIC9052 and Mandated Reporter Training.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates.

LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

Staff 3 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed large family childcare home single action door handle requirements per PIN 23-11-CCP.

LPA discussed safe sleep regulations with Staff 3 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.

(Continued on 809-C)

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: SAUCEDA, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 103911678
VISIT DATE: 12/20/2023
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LPA also informed Staff 3 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Staff 3 was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Exit interview conducted and report was reviewed with Staff 3.

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

Staff 3 was provided appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit was provided and required to be posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Pa Kou Vue
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
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