153911457-2-5-2024-57-CC-TMAZ-D26RHZ-20240205120308

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153911457
Report Date: 02/05/2024
Date Signed: 02/05/2024 12:03:56 PM

Document Has Been Signed on 02/05/2024 12:03 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:	SEPULVEDA, JENNIFER FAMILY CHILD CARE		FACILITY NUMBER:	153911457
ADMINISTRATOR:	SEPULVEDA, JENNIFER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(760) 608-3447
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93312
CAPACITY:	14	CENSUS: 8	DATE:	02/05/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Jennifer Sepulveda		TIME COMPLETED:	12:30 PM

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On 2/5/2024, Licensing Program Analyst (LPA), Theresa Marquez conducted an unannounced Inspection and was met by licensee Jennifer Sepulveda. An assistant was also present. Operating hours are Monday through Friday, 7:00 AM – 4:00 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, dining/kitchen area, the day care room, and hall bathroom are used for providing care and are accessible to day care children. All other rooms are off-limits and are made inaccessible by use of handle locks

There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no firearms or ammunition on the premises. 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 4 dogs that is inaccessible to children. Licensee is aware of child safety around pets and accepts responsibility for any action taken by pets. There are no firearms on the premises.

The swimming pool was fenced per regulation with a gate that is self-latching, self-closing, and opens away from the swimming pool. No windows or doors have direct access to the swimming pool area.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training certification will expire on 1/4/2025. Licensee’s pediatric CPR/First Aid certification expires on 2/14/2025. A review of records indicates that licensee and her assistant have immunization records on file for influenza, pertussis and measles.

Continued on LIC809-C

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2024

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: SEPULVEDA, JENNIFER FAMILY CHILD CARE	FACILITY NUMBER: 153911457
	VISIT DATE: 02/05/2024

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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).

Licensee Sepulveda 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.

There are no infants enrolled at this time. Licensee Sepulveda is aware of 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 Sepulveda 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 Sepulveda 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

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2024

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: SEPULVEDA, JENNIFER FAMILY CHILD CARE	FACILITY NUMBER: 153911457
	VISIT DATE: 02/05/2024

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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 no deficiencies were observed today.

An exit interview was conducted and report was reviewed with the licensee Jennifer Sepulveda. 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 and the Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Luisa Gavoutian	TELEPHONE: (559) 650-7879
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2024

LIC809 (FAS) - (06/04)

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