153902457-4-3-2024-57-CC-TMAZ-D3YTUA-20240403150201

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153902457
Report Date: 04/03/2024
Date Signed: 04/03/2024 03:02:13 PM

Document Has Been Signed on 04/03/2024 03:02 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	DE LEON, CAROL FAMILY CHILD CARE		FACILITY NUMBER:	153902457
ADMINISTRATOR: ADMINISTRATOR/ DIRECTOR:	DE LEON, CAROL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 331-3676
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93312
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 11	DATE:	04/03/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN: TIME VISIT/ INSPECTION BEGAN:	11:45 AM
MET WITH:	Carol De Leon		TIME COMPLETED: TIME VISIT/ INSPECTION COMPLETED:	03:15 PM

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On 4/3/2024, Licensing Program Analyst (LPA), Theresa Marquez conducted an unannounced Inspection and was met by licensee Carol De Leon. An assistant was also present. Operating hours are Monday through Friday, 7:30 AM – 5:30 PM. This is a single level home and there are no stairs. Safe toys and play equipment are observed.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed, and Licensee confirmed the living room, kitchen dining area, the daycare room, bedroom #2 and the hall bathroom are used for providing care and are accessible to day care children. All other rooms are off-limits.
There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

The outdoor play area in the backyard is fenced and there are no hazards to children present. Licensee has 1 dog that is accessible to children. Licensee is aware of child safety around pets and accepts responsibility for any action taken by pets. There is no swimming pool or bodies of water and no firearms on the premises. Firearms and ammunition were properly stored and locked separately.

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 4/9/2022. Licensee’s pediatric CPR/First Aid certification expires on 1/24/2026. A review of records indicates that licensee and her assistant have immunization records on file for influenza, pertussis and measles.

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).

Continued on LIC809-D

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: DE LEON, CAROL FAMILY CHILD CARE	FACILITY NUMBER: 153902457
	VISIT DATE: 04/03/2024

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Licensee De Leon 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 safe sleep regulations with licensee De Leon 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. LPA also informed licensee De Leon 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/.

Licensee De Leon 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.

Continued on LIC809-C

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: DE LEON, CAROL FAMILY CHILD CARE	FACILITY NUMBER: 153902457
	VISIT DATE: 04/03/2024

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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.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiencies were found: The CDPH form PM286 is not being completed with children's immunization records. (see page LIC809-D):

An exit interview was conducted, and report was reviewed with the licensee . During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the day care home. A copy of the evaluation report, Appeal Rights and the Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Theresa Marquez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/03/2024 03:02 PM - It Cannot Be Edited

Created By: Theresa Marquez On 04/03/2024 at 02:24 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: DE LEON, CAROL FAMILY CHILD CARE	FACILITY NUMBER: 153902457
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(g)(1)

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. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above. Licensee is not completing the CDPH form PM286 for children immunization records. This poses a potential health, safety or personal rights risk to children in care.
	POC Due Date: 04/24/2024
	Plan of Correction
1 2 3 4	Licensee agrees to complete the form PM286 and submit a written statement to licensing by April 24, 2024.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Luisa Gavoutian

LICENSING EVALUATOR NAME:

Theresa Marquez

LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC809 (FAS) - (06/04)

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