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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153905568
Report Date: 08/06/2021
Date Signed: 08/06/2021 03:04:18 PM

Document Has Been Signed on 08/06/2021 03:04 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:HERNANDEZ, LETICIA FAMILY CHILD CAREFACILITY NUMBER:
153905568
ADMINISTRATOR:HERNANDEZ, LETICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 721-7330
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
08/06/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Leticia HernandezTIME COMPLETED:
03:20 PM
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On 08/6/2021, Licensing Program Analyst (LPA), Ocegueda conducted an unannounced Annual Required Inspection and was met by Licensee, Leticia Hernandez. Also present were Staff #1 (S1). Licensee is Spanish Speaking and S1 are Spanish Speaking. Days and hours of operation are Monday through Friday 5:00 AM to 5:00 PM or other hours as arranged.

LPA toured the home inside and outside and a census was taken. Current facility sketch was reviewed and Licensee confirmed that the divided play rooms and one bathroom is accessible to the children. A small kitchenette in the back play room was made inaccessible by way of baby gate as was the rest of the home. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. All poisons are kept in a locked storage area. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

The fireplace located in the living room and is made inaccessible by a glass door, and baby gate 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. The home has working telephone service and LPA confirmed the phone number is 661-721-7330.

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 understands she should document 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 was reviewed and licensee understands that it should be 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. Report continued on 809-C.

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2021
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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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: HERNANDEZ, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 153905568
VISIT DATE: 08/06/2021
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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. While inspecting the backyard, LPA observed that various fruit trees were protected by thin wire fencing material. The wires on the bottom of the wire barrier on parts of the fence were sticking out in a way that created sharp edges. LPA discussed this observation with licensee and S1 who confirmed some edges were sharp. LPA took a photo of the wire fence. 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 2/8/2020. Licensee’s pediatric CPR/First Aid expires on 10/27/2021. A review of records indicates that all employees and/or volunteers have immunization records on file for 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.
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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/06/2021 03:04 PM - It Cannot Be Edited


Created By: Ruby Ocegueda On 08/06/2021 at 02:14 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: HERNANDEZ, LETICIA FAMILY CHILD CARE
FACILITY NUMBER: 153905568

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/03/2021
Section Cited
CCR
102417(g)

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Operation of a Family Child Care Home(g)The home shall be free from defects or conditions which might endanger a child...This requirement was not met as evidenced by: observation. During the inspection of the accessible back yard, it was observed that there were sharp wires sticking out from a wire
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Licensee stated that wire fencing would be replaced. Licensee stated she will continue to monitor the wire fence for any sharp edges in the future. Licensee will send photo of new wire fence barrier by POC date:9/3/2021
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fence meant to create a barrier for fruit trees. This poses a potential risk to the health, safety and or personal rights of children in care.
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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:Michael Duarte
LICENSING EVALUATOR NAME:Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:
DATE: 08/06/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2021


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