163911155-5-31-2023-57-CC-APIO-CSCPYP-20230531114417

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 163911155
Report Date: 05/31/2023
Date Signed: 05/31/2023 11:44:39 AM

Document Has Been Signed on 05/31/2023 11:44 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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	RIOS DE GONZALEZ, ROSA FAMILY CHILD CARE		FACILITY NUMBER:	163911155
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	05/31/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Rosa Rios de Gonzalez		TIME COMPLETED:	12:00 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

On 05/31/2023 Licensing Program Analysts (LPAs) Adrian Pizano and Ruby Ocegueda, conducted an unannounced Annual Required Inspection and was met by Licensee, Rosa Rios de Gonzalez. Also present was adult #1 who will be assisting licensee on occasion. Licensee is Spanish Speaking and Ruby Ocegueda assisted with interpretation. Days and hours of operation are Monday through Friday 6am-6pm.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that bathroom, dining room, living room and outside side yard are used for providing care and are accessible to children. Bedrooms were observed to have door knob covers. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. Today, kitchen which is identified as an off-limit area was accessible. The kitchen lead to the open laundry room and unlocked garage. Upon entering the garage LPAs noticed three cans of Raid poison placed on a shelf approximately 5 feet tall. The garage was also accessible through the side yard that had an unlocked door. Licensee had one infant in care that could not reach the poison. Today licensee removed poison and other cleaning products from garage and stored them in a locked storage room. In the accessible bathroom there was a disinfectant spray. The under sink cabinet had a safety latch that was not locked in place today. Infant does not use restroom as he/she is not potty trained yet. There are no other children in care or enrolled at this time. LPA’s reviewed the regulation relating to keeping poisons locked and other potentially hazardous items 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. 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) 904-4398.

SUPERVISORS NAME: Luisa Gavoutian
LICENSING EVALUATOR NAME: Adrian Pizano
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: RIOS DE GONZALEZ, ROSA FAMILY CHILD CARE	FACILITY NUMBER: 163911155
	VISIT DATE: 05/31/2023

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
26
27
28
29
30
31
32

There is currently one infant in care. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles 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. Individual Infant Sleeping Plan was reviewed and provided to licensee. 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 inspected. 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 05/24/2023. Licensee’s pediatric CPR/First Aid expires on 09/11/2023. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

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. LPA’s discussed all requirements for assistants who provide care and supervision as well as provided her with licensing forms.

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, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of 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: Adrian Pizano
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3

Document Has Been Signed on 05/31/2023 11:44 AM - It Cannot Be Edited

Created By: Adrian Pizano On 05/31/2023 at 10:49 AM

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: RIOS DE GONZALEZ, ROSA FAMILY CHILD CARE	FACILITY NUMBER: 163911155
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/31/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(4)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation the licensee did not comply with the section cited above. LPAs Pizano and Ocegueda observed there were three cans of raid poison in the accessible garage placed on a cabinet approximatley 5 feet tall. Under the bathroom sink there was disinfectant spray accessible to children. threre was oe infant in care who could not access the poison. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/06/2023
	Plan of Correction
1 2 3 4	Todays LPAs reviewed regulations stated above. Licensee removed poisons from garage and bathroom making all items inaccessble. Licensee stored items in a locked storage room. Deficiency cleared today 05/31/2023.

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:

Adrian Pizano

LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3