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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911755
Report Date: 04/21/2022
Date Signed: 04/25/2022 04:40:23 PM

Document Has Been Signed on 04/25/2022 04:40 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:CHAVEZ OROZCO, ADRIANA FAMILY CHILD CAREFACILITY NUMBER:
153911755
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/21/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Adriana Chavez OrozcoTIME COMPLETED:
01:40 PM
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Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On April 21, 2022, Licensing Program Analyst (LPA), Norma Lomeli met with Spanish-speaking Applicant, Adriana Chavez Orozco for a pre-licensing inspection. Applicant, her husband, her adult son 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 and hallway bathroom. Off-limits rooms are made inaccessible by use of key locks, lever locks and plastic door knob covers.
  • There is a fireplace in the living room that applicant states it will not be used during day-care hours.
  • LPA observed children size furniture, safe toys and books for the children. Children will nap in the living room on cots. Infants will nap in a play yard. There is a diaper changing station in the living room. There is a high chair in the dining room. There is a flat screen television mounted onto the living room wall. 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.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2022
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: CHAVEZ OROZCO, ADRIANA FAMILY CHILD CARE
FACILITY NUMBER: 153911755
VISIT DATE: 04/21/2022
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Applicant is advised the following items must be corrected and second prelicensing inspection within 30 days to avoid possible withdraw.
  • LPA will inspect the three bedrooms and master bathroom that were key locked during the inspection. Applicant stated that her adult son took the keys to work with him to make copies of the keys.
  • LPA observed two windows and one door from the side run of the home that have direct access to the in-ground pool. Applicant will install a gate on the side run of the home that is self closing/self latching and meets Title 22 Regulations.
  • LPA observed a window from the home that has direct access to the in-ground pool. There is a second window that is a fixed window. Applicant will make the window that has direct access to the in-ground pool inaccessible.
  • LPA observed that the two pool gates are not self latching/ self closing.

Pending verification of corrections of the above items, a second prelicensing inspection and a final review of her application, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022
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: CHAVEZ OROZCO, ADRIANA FAMILY CHILD CARE
FACILITY NUMBER: 153911755
VISIT DATE: 04/21/2022
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  • Fenced backyard has a sodded and cemented area for the day care children. There is a patio porch for shade.
  • SB 792 immunizations verified and on file.
  • Applicant completed the Mandated Reporter Training on June 23, 2021.
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
  • Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. 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.

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. Applicant 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 5:30am to 5:30pm 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.



(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: CHAVEZ OROZCO, ADRIANA FAMILY CHILD CARE
FACILITY NUMBER: 153911755
VISIT DATE: 04/21/2022
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  • Applicant’s Pediatric CPR and First Aid certification was completed through Pediatric Plus Emergency Medical Services Authority stickers (EMSA) and expires on June 27, 2023.
  • Preventative Health and Safety with Prevention of Lead exposure certification was completed on August 19, 2021.
  • Knives are stored in top of the refrigerator. Medications are stored inside a hallway closet on a top shelf. Cleaning compounds are stored inside the garage. Others are stored the cabinet that is located underneath the kitchen sink that is made inaccessible by a child proof safety latch.
  • 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 is an in-ground pool that is fenced with white rod iron fence in accordance with Title 22 Regulations. The gate is not self-latching/self-closing and does not swing away from the pool. The latching device is located no more than six inches from the top of the gate.
  • There are two dogs that are kept in the gated pool area. There are two Cockatoos that are kept inside a bird cage that is located in the backyard. 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 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.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022
LIC809 (FAS) - (06/04)
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