153910671-2-10-2023-57-CC-DQAZ-CNWRC4-20230210115345

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153910671
Report Date: 02/10/2023
Date Signed: 02/10/2023 11:53:53 AM

Document Has Been Signed on 02/10/2023 11:53 AM - 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:	BORJON-COSBY, CYNTHIA FAMILY CHILD CARE		FACILITY NUMBER:	153910671
ADMINISTRATOR:	BORJON-COSBY, CYNTHIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 444-2667
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93311
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 12	DATE:	02/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Cynthia Borjon-Cosby		TIME COMPLETED:	12:00 PM

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On 02/10/2023, Licensing Program Analyst (LPA) Daniel Alvarez, conducted an unannounced Annual Required 1 year Inspection and was met by Licensee, Cynthia Borjon-Cosby. Also present was Staff #1 (S1) and 11 day care children. Days and hours of operation are Monday – Friday, from 7:30 AM – 05:30 PM, and 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 family room, living room, dining room, kitchen, office, and hall bathroom are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of doorknob covers. There are no bodies of water or firearms on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are inaccessible. Fireplace located in the family room is screened and is not used during day-care hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (661) 444-2667.

Licensee has one infant enrolled at this time. LPA discussed the 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 documents 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 provided and will 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. LPA discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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. (CONTINUED ON 809-C)

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Daniel Q Alvarez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

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: BORJON-COSBY, CYNTHIA FAMILY CHILD CARE	FACILITY NUMBER: 153910671
	VISIT DATE: 02/10/2023

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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 could not provided proof of her Mandated Reporter training that she completed on 01/31/23. Licensee’s pediatric CPR/First Aid expires on 02/05/2024. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis, and measles. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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. 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/childqanda.htm.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

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: Susie Fanning
LICENSING EVALUATOR NAME: Daniel Q Alvarez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/10/2023 11:53 AM - It Cannot Be Edited

Created By: Daniel Q Alvarez On 02/10/2023 at 11:39 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: BORJON-COSBY, CYNTHIA FAMILY CHILD CARE	FACILITY NUMBER: 153910671
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. 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 stated she renewed her Mandated Reporter training on 1/31/2023 but had not received her certificate, therefore could not provide proof that her Mandated Reporter training was current. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/10/2023
	Plan of Correction
1 2 3 4	Licensee stated she will continue to reach out to the Mandated Reporter vendor to obtain her ccertificate and submit proof to Community Care Licensing (CCL).

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:

Susie Fanning

LICENSING EVALUATOR NAME:

Daniel Q Alvarez

LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023

LIC809 (FAS) - (06/04)

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