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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203910689
Report Date: 01/12/2024
Date Signed: 01/12/2024 12:28:42 PM

Document Has Been Signed on 01/12/2024 12:28 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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MORENO, BERTHA FAMILY CHILD CAREFACILITY NUMBER:
203910689
ADMINISTRATOR:MORENO, BERTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 975-5911
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
01/12/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Bertha MorenoTIME COMPLETED:
12:45 PM
NARRATIVE
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On 1/12/2024 Licensing Program Analyst (LPA), Stephanie Vega-Gonzalez conducted an unannounced Annual Required Inspection and was met by licensee, Bertha Moreno.

LPA knocked rang the doorbell and Licensee Bertha Moreno answered. LPA introduced themselves and showed Licensee work identification. LPA asked Licensee if Licensee spoke Spanish, Licensee answered back in English. Licensee informed LPA that she was going to take the children to school and that she would be back in 30 minutes. LPA asked Licensee how many children she had; Licensee stated she had 8 children. LPA stayed in vehicle to create LIC809 report, and observed as two children were picked up by an adult in a white van. LPA called Licensee via telephone and asked Licensee if she spoke Spanish. Licensee stated that she did. LPA translated in Spanish and informed Licensee if she was going to indeed take children to school. Licensee stated no. LPA then asked why Licensee had informed LPA that she was going to take children and needed 30 minutes. Licensee stated that she was waiting for Assistant to arrive. LPA then informed Licensee that LPA will start inspection and ended call. LPA rang door bell and was greeted by licensee who informed her that she wasn't sure if children were going to get picked up or if she was going to take children to school. LPA walked into the home and observed that children were located in the converted garage day care room. LPA observed 2 infants and 6 older children. Yet, when LPA had originally arrived there were 2 infants and 8 older children. LPA explained to Licensee that she was not meeting her capacity. Licensee stated that she understood. Within forty minutes Assistant 1 arrived at facility and ratio and capacity was met. Days and hours of operation are Monday through Saturday from 1:00am to 11:00pm. Licensee stated that she offer’s overnight care depending on need of the family.

LPA reviewed current facility sketch and confirmed that the living room, kitchen, dining hallway restroom, bedroom 1, converted garage play room, play room restroom, and back yard are used for providing care and are accessible to children. On today’s date Licensee had requested to make Bedroom 4 accessible to children in care.

(Continue on LIC809-C)

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2024
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 01/12/2024 12:28 PM - It Cannot Be Edited


Created By: Stephanie Vega-Gonzalez On 01/12/2024 at 10:59 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: MORENO, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 203910689

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2024

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
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Based on observation, the licensee did not comply with the section cited above in that LPA observed in the play room's restroom a RAID roach killer can, sink drain full of water, toilet not having screw covers, toothpaste. In the Play room furniture not anchored, batteries scattered throughout the facility, water collected in 2 bins in backyard, trampoline zipper not closed, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/26/2024
Plan of Correction
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Licensee stated that she will ensure to have all RAID roach or bug killer under lock and key. Licensee stated that she will ensure to not have batteries scattered throughout the home, and have items inaccessible to children in care that may pose a potential risk. Licensee stated that she will submit proof to the department of trampoline being made inaccessible, sink being fixed, and toilet screw covers being put on by due date of 1/26/2024.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in Assistant 1 did not have record of their Mandated Reporter Training, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/26/2024
Plan of Correction
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Licensee stated that Assistant 1 will completed the required training and submit proof to the Department by due date of 1/26/2024.
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: 01/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/12/2024 12:28 PM - It Cannot Be Edited


Created By: Stephanie Vega-Gonzalez On 01/12/2024 at 10:59 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: MORENO, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 203910689

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/12/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that Assistant 1 did not have their immunization's records available for LPA to review, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/26/2024
Plan of Correction
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Licensee stated that she will provide proof to the department by POC due date.
Type B
Section Cited
CCR
102416.5(a)
102416.5 Staffing Ratio and Capacity
(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.
This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above in that LPA observed 2 infants in care and 6 older children with no Assistant being present, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/26/2024
Plan of Correction
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Licensee stated that they will review the ratio and capacity. Licensee stated that they will write a statement in how they will ensure to keep the maximum number of children when care is being provided by POC due date of 1/26/2023.
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: 01/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/12/2024


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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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MORENO, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 203910689
VISIT DATE: 01/12/2024
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LPA inspected Bedroom 4 and found room to be suitable for care. As of 1/12/2024 Bedroom 4 can be used for providing care to children. Facility sketch was updated and licensee signed document and made a copy for themselves.. All other rooms are off-limits and made inaccessible by locked doors.

There is a hot tub in the backyard that is empty and had a cover that is latched. Children do not have access to the interior of the hot tub. Licensee stated that hot tub will eventually be filled, and a new cover will be purchased. Licensee stated that she will notify the department of the update once it occurs.

There are no firearms or ammunition on the premises. LPA observed in the play room's restroom a RAID roach killer can, sink drain full of water that will not drain, toilet not having screw covers, toothpaste. In the Play room furniture not anchored and are loose when touched, various double AA batteries scattered throughout the facility. LPA observed as Licensee picked up various double AA batteries and placed them in a inaccessible location. In the backyard LPA observed water collected in one large bin, and in one small bin. LPA observed as Licensee dumped out water from the bins during inspection. No children were present in the backyard. LPA observed that Licensee had a trampoline that did not have a latter. Yet, LPA observed that the zipper on the trampoline was broken. LPA reviewed best practice with Licensee, is for zipper to close, in order to fully make trampoline inaccessible. Licensee stated she understood.

LPA observed two small dogs. Licensee understand the liability of pets around day care children and accepts responsibilities of any action taken by pets.

There is one fireplace in the home located in the living room and 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.

This is a single level home and there are no stairs. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559) 975-5911.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. The outdoor play area in the backyard is fenced and there are no hazards to children present.


(Continue on LIC809-C)
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MORENO, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 203910689
VISIT DATE: 01/12/2024
NARRATIVE
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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 11/14/2022 . Licensee’s pediatric CPR/First Aid certification expires on 3/3/2024. Assistant 1 does not have a Mandated Reporter Training on record. Assistant 1 pediatric CPR/First Aid certification expires on 6/13/2025. A review of records indicates that licensee did not have Assistant 1’s file for review which also includes, their immunization record for 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, Bertha Moreno 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 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 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.

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/.

(Continue on LIC809-C)

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
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-CC, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MORENO, BERTHA FAMILY CHILD CARE
FACILITY NUMBER: 203910689
VISIT DATE: 01/12/2024
NARRATIVE
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Licensee 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 During the exit interview, the licensee 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 deficiencies are being cited: (see next page).

Licensee, Bertha Moreno 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: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Stephanie Vega-Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2024
LIC809 (FAS) - (06/04)
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