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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203908603
Report Date: 01/17/2023
Date Signed: 01/17/2023 05:39:13 PM

Document Has Been Signed on 01/17/2023 05:39 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:VARGAS, MARIA FAMILY CHILD CAREFACILITY NUMBER:
203908603
ADMINISTRATOR:VARGAS, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 481-5134
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
01/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:01 PM
MET WITH:VARGAS, MARIATIME COMPLETED:
05:45 PM
NARRATIVE
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Licensing Program Analysts (LPA) Stephanie Vega-Gonzalez arrived at the facility to conduct a case management and other inspections. LPA met with Licensee Marai Vargas who accompanied LPA during tour of facility both inside and outside and a census was taken. Also present on today's visit was Licensee's Assistant, Gabriela Bautista.

During today’s inspection it was revealed that Licensee went on an out of the country vacation from December 19, 2022 to December 28, 2022 and allowed Assistant Gabriela Bautista to care for day care children alone. It was revealed during inspection that Licensee did not contact Community Care Licensee to update care status. LPA reviewed Reporting Requirements with Licensee.

In addition, during today’s inspection LPA observed an alcohol beverage cabinet containing over twenty bottles of liquor that were accessible to children in the Dinning Area. LPA informed Licensee that alcohol bottles had to be inaccessible to children. LPA observed that Licensee moved all of the cabinet along with bottles in Master Bedroom that is inaccessible by a doorknob spinner.

During the outdoor inspection, LPA observed that Swimming pool is fenced per regulation. The pool gate is self-latching, self-closing and opens away from the swimming pool. LPA observed that the outside gate of the pool fence was surrounded by various tables, big planters, and a bench. LPA reviewed pool regulations with Licensee.

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. A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the facility representative Licensee Marai Vargas

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/17/2023
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 01/17/2023 05:39 PM - It Cannot Be Edited


Created By: Stephanie Vega-Gonzalez On 01/17/2023 at 05:04 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: VARGAS, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 203908603

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/24/2023
Section Cited
CCR
102416.2(b)(3)(C)

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102416.2 Reporting Requirements (b) The licensee shall report to the Department any of the events as specified in Health and Safety Code ...(3) Health and Safety Code Section 1597.467(b)(1) provides in part:(C) Any unusual incident or child absence that threatens the physical or emotional health
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Licensee stated that they will watch the following video, and write a statement on what they have learned. Licensee stated they will submit the statement to CCL by POC due date. Video title: Child Care Reporting Requirements.
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 or safety of any child." This requirement was not met as evidenced by, Licensee did not contact Community Care Licensing to report Unusual Incident. This poses a potential health/safety risk to children in care.
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https://ccld.childcarevideos.org/family-child-care-providers/supervising-children-in-family-child-care/
In addition Licensee stated they will submit a LIC624B Unusual Incident Report to POC.

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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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Stephanie Vega-Gonzalez
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2023


LIC809 (FAS) - (06/04)
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