163905070-9-24-2021-04-CC-ROCA-C76NJ5-20210924102945

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 163905070
Report Date: 09/24/2021
Date Signed: 09/24/2021 10:30:36 AM

Document Has Been Signed on 09/24/2021 10:30 AM - 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:	GONZALEZ, YOLANDA FAMILY CHILD CARE		FACILITY NUMBER:	163905070
ADMINISTRATOR:	GONZALEZ, YOLANDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 816-3156
CITY:	LEMOORE	STATE: CA	ZIP CODE:	93245
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 2	DATE:	09/24/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Gonzalez, Yolanda		TIME COMPLETED:	10:45 AM

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On 09/24/2021 Licensing Program Analyst (LPA), Ruby Ocegueda conducted an unannounced Annual Required Inspection and was met by Licensee, Yolanda Gonzalez. Upon arriving, LPA Ocegueda conducted a Covid-19 safety screening. Licensee is Spanish Speaking. Days and hours of operation are Monday through Friday 5:00 AM – 5:00 PM.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that the kitchen, bathroom, family room, dining area front day care room are used for care and are accessible to children. Bedroom #4 was previously approved for care but licensee currently uses it to store toys. All rooms (including bedroom #4) are off-limits and made inaccessible by use of door knob safety covers. There is no swimming pool or other bodies of water on the premises. Firearms and ammunition are stored and locked separately. All poisons are kept in a locked storage area. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

The fireplace located in the living room is made inaccessible by a glass door and will not be in use during daycare hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559)816-3156.

LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care. LPA reviewed the requirement for cribs and play yards to be kept free from all loose articles (including blankets) 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 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. Infant in this facility sleep in the family room. Continued 809-C.

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021

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: GONZALEZ, YOLANDA FAMILY CHILD CARE	FACILITY NUMBER: 163905070
	VISIT DATE: 09/24/2021

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LPA reviewed Individual Infant Sleeping Plan with licensee and the requirement for it to be 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. Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was completed on 8/9/2023. Licensee’s pediatric CPR/First Aid expires on 09/11/2023. A previous review of records indicates that all employees and/or volunteers have immunization records on file for pertussis and measles. Licensee showed proof of flu vaccine declination statement.

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.

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. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

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: Michael Duarte
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2021

LIC809 (FAS) - (06/04)

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