153911714-6-27-2024-57-CC-CBUS-D6MSAF-20240627134215

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153911714
Report Date: 06/27/2024
Date Signed: 06/27/2024 01:42:26 PM

Document Has Been Signed on 06/27/2024 01:42 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
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	ALBAYEROS, HILDA FAMILY CHILD CARE		FACILITY NUMBER:	153911714
ADMINISTRATOR/ DIRECTOR:	ALBAYEROS, HILDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 549-4055
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93313
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 3	CENSUS: 3	DATE:	06/27/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:25 AM
MET WITH:	HIlda Albayeros		TIME VISIT/ INSPECTION COMPLETED:	01:55 PM

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On 06/27/2024 Licensing Program Analyst (LPA), Christopher Burnias conducted an Unannounced Annual Random Inspection and was met by licensee Hilda Albayeros. Days and hours of operation are Monday through Friday from 5:45AM to 5:00 PM. Later hours can be requested by parents and Licensee is by appointment only on the weekends

LPA toured the home inside and outside and a census was taken. LPA reviewed current facility sketch and confirmed that the kitchen, bathroom and living room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of a baby gate, locks, and doorknob spinners.

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.

This is a two-story home and stairs are gated when children under age 5 years old are present. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (661) 549-4055.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. The outdoor area is inaccessible and not for daycare use. Capacity as specified on the license is being maintained.

**Continued on LIC 809C**

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Christopher Burnias
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024

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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Document Has Been Signed on 06/27/2024 01:42 PM - It Cannot Be Edited

Created By: Christopher Burnias On 06/27/2024 at 12:20 PM

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: ALBAYEROS, HILDA FAMILY CHILD CARE	FACILITY NUMBER: 153911714
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/27/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102421(a)

Child's Records

(a) The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on records review, the licensee did not comply with the section cited above. 3 out of 3 children's records had incomplete or missing documents (LIC 700, LIC 627, Infant Sleep Log) which poses a potential health, safety or personal rights risk to persons in care. LPA advised Licensee to have all documents corrrected and submit proof of correction to the Department for verification
	POC Due Date: 07/05/2024
	Plan of Correction
1 2 3 4	Licensee will have all documents completed/updated and will email copies of documents to LPA.

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:

Luisa Gavoutian

LICENSING EVALUATOR NAME:

Christopher Burnias

LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024

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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ALBAYEROS, HILDA FAMILY CHILD CARE	FACILITY NUMBER: 153911714
	VISIT DATE: 06/27/2024

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LPA reviewed a sample of children’s files and observed files were incomplete with missing emergency information. During inspection of children's files, LPA observed multiple forms incomplete. LIC 700 incomplete, LIC 282 incomplete, LIC 627 incomplete. Infant Sleeping Log and Roster were present but not current or maintained. LPA advised Licensee to have all documents corrected and submit proof of correction to the Department for verification. Licensee’s Mandated Reporter Training was completed on 01/30/24. Licensee’s pediatric CPR/First Aid certification expires on 02/03/25. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

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 Hilda Albayeros 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.

LPA discussed safe sleep regulations with licensee Hilda Albayeros and discussed 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 Hilda Albayeros 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 LIC 809C**

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Christopher Burnias
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO SOUTH CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ALBAYEROS, HILDA FAMILY CHILD CARE	FACILITY NUMBER: 153911714
	VISIT DATE: 06/27/2024

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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 Hilda Albayeros 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.

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.

Exit interview conducted and report was reviewed with licensee Hilda Albayeros. During the exit interview, the licensee Hilda Albayeros confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiency is being cited: (see next page).

Licensee Hilda Albayeros was provided 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: Luisa Gavoutian
LICENSING EVALUATOR NAME: Christopher Burnias
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024

LIC809 (FAS) - (06/04)

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