153911304-11-10-2021-04-CC-CHAS-C8MSKA-20211110125626

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153911304
Report Date: 11/10/2021
Date Signed: 11/10/2021 12:56:34 PM

Document Has Been Signed on 11/10/2021 12:56 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:	ARGUELLO, ESBEYDY FAMILY CHILD CARE		FACILITY NUMBER:	153911304
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	11/10/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Esbeydy Arguello		TIME COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 11/10/21 Licensing Program Analyst, (LPA) Caroline Harris conducted an unannounced annual inspection. LPA met with Licensee, Esbeydy Arguello. LPA conducted a tour of the home, inside as shown on the facility sketches (LIC 999A) provided. The LPA observed all required licensing forms to be posted in a visible location for authorized representatives to view them. A census was taken and there were three day care children present. No pets were observed during today's visit. The LPA observed inaccessible rooms to be off limits to children by the use of door knob spinners. Currently the backyard if off-limits to day-care children, prior to use the licensee will call Licensing to come clear the backyard for day-care use. The areas of the home that day-care children have access to are living room, dining room, kitchen, playroom, and hall bathroom. There were no poisons observed on the premises accessible to children. Licensee is aware that poisons are required to be locked and inaccessible to children. Cleaning compounds, medications and other hazardous items are required to be inaccessible to children. During the inspection, the LPA observed three different drawers in the kitchen to contain items such as batteries, pointed scissors, vitamins and pointed meat thermometer, that were assessable to children, as the child proof latches were not working. There are no firearms or ammunition present at this facility. There is a fireplace in the home that will not be used during day-care hours. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. The licensee has a complete first aid kit, including bandages, scissor, thermometer, gloves and a first aid manual. There are no stairs in the home. There is a working telephone and the above telephone number was verified. Adequate supervision is being provided during this visit. Capacity as specified on the license is being maintained.

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021

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: ARGUELLO, ESBEYDY FAMILY CHILD CARE	FACILITY NUMBER: 153911304
	VISIT DATE: 11/10/2021

NARRATIVE

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LPA reviewed five children’s files. All required licensing documents were observed in each of the children’s files, including a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Licensee also maintains documentation of immunizations for the children. Incidental Medical Services (IMS) policy was discussed. 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.

Fire drills are conducted and documented with the date, time and how many children present, every six months. Licensee is aware that children are never to be left in parked vehicles. 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. 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. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice. Pediatric CPR/First Aid are current and expire on 6/19/23. Licensee maintains documentation of immunizations against pertussis, measles and influenza for herself. Days and hours of operation are Monday – Friday; 7:00 AM –6:00 PM.

An exit interview was conducted with the Licensee. LPA reviewed with licensee the Mandated Child Abuse Reporter Training (AB 1207), which the licensee completed on 6/18/20. It is required to be updated every two years. The licensee currently has two infants in care. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage 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.

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/10/2021 12:56 PM - It Cannot Be Edited

Created By: Caroline Harris On 11/10/2021 at 11:47 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: ARGUELLO, ESBEYDY FAMILY CHILD CARE	FACILITY NUMBER: 153911304
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/10/2021

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(4)

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: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations, the licensee did not comply with the section cited above as the LPA observed three different drawers in the kitchen to contain items such as batteries, pointed scissors, vitamins and pointed meat thermometer, that were assessable to children, as the child proof latches were not working. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/12/2021
	Plan of Correction
1 2 3 4	During the inspection, the licensee removed keep out of reach items from the drawers until the child proof latches could be fixed. The licensee agrees to send pictures to the LPA, showing the child proof latches being secured by the due date of 11/12/21.

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:

Alice Juarez

LICENSING EVALUATOR NAME:

Caroline Harris

LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021

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: ARGUELLO, ESBEYDY FAMILY CHILD CARE	FACILITY NUMBER: 153911304
	VISIT DATE: 11/10/2021

NARRATIVE

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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 (0-24 months) 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 is 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. Information on Lead Poisoning was also provided to the licensee and she was informed that the information is required to be posted on the parent board. The LPA and licensee discussed the Community Care Licensing website: www.ccld.ca.gov. which provides access to Provider Information Notifications (PINS), Quarterly Updates that inform licensees of new legislation and regulations, training's, and Licensing forms and updated information. The licensee was also advised that it is her responsibility to stay current with regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are found (see next page): 809 D

An exit interview was conducted and a copy of this report (along with appeal rights) was provided to the licensee, Esbeydy Arguello and was reviewed. This report shall be made available to the public upon request. The LIC 9213 Notice of Site Visit form was provided to the licensee and must remain posted for 30 days.

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.

SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Caroline Harris
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021

LIC809 (FAS) - (06/04)

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