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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153908517
Report Date: 09/10/2021
Date Signed: 09/10/2021 01:22:49 PM

Document Has Been Signed on 09/10/2021 01:22 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:ESPINOZA, CATALINA FAMILY CHILD CAREFACILITY NUMBER:
153908517
ADMINISTRATOR:ESPINOZA, CATALINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 709-5856
CITY:DELANOSTATE: CAZIP CODE:
93215
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
09/10/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Catalina EspinozaTIME COMPLETED:
01:40 PM
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On 9/10/2021, Licensing Program Analyst (LPA), Ruby Ocegueda, conducted an unannounced Annual Required Inspection and was met by Licensee, Catalina Espinoza. Also present was/were Staff #1 (S1). Licensee is Spanish Speaking and Days and hours of operation are Monday – Friday 5:00 AM – 5:00 PM or other hours as arranged.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed. There is a day care entrance on the left side of the home. LPA inspected the play room and the bathroom. The rest of the home is off limits and made inaccessible by way of baby gate. 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.

There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Stairs are are made inaccessible by way of baby gate and are located in an inaccessible part of the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (661) 709-5856

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. LPA reviewed requirement to check on sleeping infants every fifteen minutes and to 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 during naps as they will nap in the play room Individual Infant Sleeping Plan was reviewed and licensee understands that it should be 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 809-C

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE: DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/10/2021
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: ESPINOZA, CATALINA FAMILY CHILD CARE
FACILITY NUMBER: 153908517
VISIT DATE: 09/10/2021
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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 and there are no hazards to children present. 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 3/8/2021. Licensee’s pediatric CPR/First Aid expires on 4/17/2023. A file review revealed that licensee and staff employees have immunization records on file for pertussis and measles. Written declination statement for flu immunization was observed.

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. Visit is provided and required to be posted for 30 days.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

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: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
LIC809 (FAS) - (06/04)
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