203911297-12-17-2024-04-CC-JROZ-DC2UY2-20241217145913

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 203911297
Report Date: 12/17/2024
Date Signed: 12/17/2024 03:00:12 PM

Document Has Been Signed on 12/17/2024 03:00 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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	ROLLINS, MARTHA FAMILY CHILD CARE		FACILITY NUMBER:	203911297
ADMINISTRATOR/ DIRECTOR:	ROLLINS, MARTHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 718-3449
CITY:	MADERA	STATE: CA	ZIP CODE:	93637
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	12/17/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:00 PM
MET WITH:	Martha Rollins		TIME VISIT/ INSPECTION COMPLETED:	03:00 PM

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On 12/17/2024 Licensing Program Analyst (LPA), Julio Rodriguez conducted an unannounced 1 year required Inspection and was met by licensee Martha Rollins. Also present was licensee’s husband. Days and hours of operation are Monday through Friday 7:30 AM to 5:30 PM.

LPA toured the home inside and outside and a census was taken. Licensee confirmed that the kitchen, nook, children play area, dining room, and living room are accessible to children. All other rooms are off-limits and made inaccessible by use of a baby gate and doorknob spinners.

There is no swimming pool or other bodies of water on the premises.LPA observed an empty hot tub in the backyard which is made inaccessible by a tight fitted locked cover. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

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. LPA observed toys and play equipment in play area. The home has working telephone service and LPA confirmed the phone number is (559) 718-3449.

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. LPA observed several potholes near children play structure. Licensee states she is currently not utilizing outdoor area for children due to cold weather. Licensee agreed to fill in potholes prior to making area accessible to children. The licensee has 2 dogs that are inaccessible to children and 3 cats that are accessible to the children. The 2 dogs are inside and are in inaccessible areas. The licensee is aware of child safety around pets and accepts responsibility for any action taken by pets. Capacity as specified on the license is being maintained.

Continued on 809-C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Julio Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ROLLINS, MARTHA FAMILY CHILD CARE	FACILITY NUMBER: 203911297
	VISIT DATE: 12/17/2024

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LPA reviewed a sample of children’s files and observed one child did not have immunization record on file. Licensee was directed to submit proof to community care licensing. Licensee’s Mandated Reporter Training was completed on 01/10/2024. Licensee’s pediatric CPR/First Aid certification expires on 03/25/25. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, 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 was 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.

Licensee states she is currently not providing medication to children. 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/.

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.

Continued on 809-C

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Julio Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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 RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ROLLINS, MARTHA FAMILY CHILD CARE	FACILITY NUMBER: 203911297
	VISIT DATE: 12/17/2024

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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 Martha Rollins. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, of the California Code of Regulations, the following deficiencies are being cited: (see next page).

Licensee 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: Julio Rodriguez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/17/2024 03:00 PM - It Cannot Be Edited

Created By: Julio Rodriguez On 12/17/2024 at 02:34 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: ROLLINS, MARTHA FAMILY CHILD CARE	FACILITY NUMBER: 203911297
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Licensee's assistant did not have current mandated reporter training completed. Licensee was directed to submit proof to community care licensing.
	POC Due Date: 01/03/2025
	Plan of Correction
1 2 3 4	Licensee will have assistant complete training and will submit proof of completion to community care licensing.

Type B

Section Cited

CCR

102418(g)

Immunizations

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Licensee did no have immunzation records for one child enrolled in her family child care home. Licensee was directed to obtain immunization records and submit proof to community care licensing.
	POC Due Date: 01/03/2025
	Plan of Correction
1 2 3 4	Licensee will obtain immunization record and submit proof to community care licensing.

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:

Julio Rodriguez

LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC809 (FAS) - (06/04)

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