153911697-3-7-2022-04-CC-NLOI-CCAUM8-20220307144156

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153911697
Report Date: 03/07/2022
Date Signed: 03/07/2022 02:42:10 PM

Document Has Been Signed on 03/07/2022 02:42 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:	RUIZ REYES, MAYRA FAMILY CHILD CARE		FACILITY NUMBER:	153911697
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	03/07/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Mayra Ruiz Reyes		TIME COMPLETED:	03:00 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	Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On March 7, 2022, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Mayra Reyes Ruiz for a pre-licensing inspection. Applicant, her husband and one minor child reside in the home. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: This is a single story, three bedrooms and two bathrooms home and children will have access to the living room, dining room, kitchen, bedroom #1 (day care room) and hallway bathroom. Off-limits rooms are made inaccessible by use of key locks and plastic door knob covers. There is no fireplace in the home. LPA observed in bedroom #1 (day care room); children size furniture, safe toys, puzzles and books for the children. Also observed a bed and an infant crib There is an infant swing in the living room. Children will nap in bedroom #1 on mats. Infants will nap in a crib. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. Facility has 2A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. Applicant’s Pediatric CPR and First Aid certification was completed through American Heart Association Emergency Medical Services Authority stickers (EMSA) and expires on August 25, 2023. (Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2022

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: RUIZ REYES, MAYRA FAMILY CHILD CARE	FACILITY NUMBER: 153911697
	VISIT DATE: 03/07/2022

NARRATIVE

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Preventative Health and Safety with Prevention of Lead exposure certification was completed on February 12, 2022.
Knives are stored inside the knife block that is located inside a bottom kitchen cabinet that is made inaccessible by the use of a magnetic lock. Medications are stored inside a top kitchen cabinet. Cleaning compounds are stored in the bottom cabinet that is located underneath the kitchen sink and made inaccessible by the use of a magnetic lock.
Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
There are no bodies of water in the home or premises.
There is a dog that is kept on the gated side run of the home. There are seven turtles and three tortoises. Two turtles are kept in an aquarium in the garage. Five turtles and two tortoises are kept in the gated side run of the home. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
Applicant states there are no firearms, ammunition or poisons in the home or premises.
Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
Applicant states she will not be transporting day care children. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.
Fenced backyard has a cemented area for the day care children to play.
SB 792 immunizations verified and on file.
Applicant completed the Mandated Reporter Training on February 18, 2022.
LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2022

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: RUIZ REYES, MAYRA FAMILY CHILD CARE	FACILITY NUMBER: 153911697
	VISIT DATE: 03/07/2022

NARRATIVE

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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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. She is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday from 7:30 AM to 5:30 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

Licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended effective March 7, 2022.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2022

LIC809 (FAS) - (06/04)

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