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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503608001
Report Date: 06/27/2024
Date Signed: 06/27/2024 05:42:46 PM

Document Has Been Signed on 06/27/2024 05:42 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:COLLINS, DENISEFACILITY NUMBER:
503608001
ADMINISTRATOR/
DIRECTOR:		COLLINS, DENISEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 577-1627
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
06/27/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Denise CollinsTIME VISIT/
INSPECTION COMPLETED:
06:00 PM
NARRATIVE
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On 06/27/2024, Licensing Program Analyst (LPA) Valerie Mireles conducted an unannounced Annual Random Inspection and was met by licensee Denise Collins. LPA toured the home inside and outside and a census was taken. There were five children present during today’s inspection. Days and hours of operation are Monday through Friday 7:30 AM – 5:00 PM.

LPA reviewed current facility sketch and confirmed that the family room, kitchen, dining room, hallway bathroom and living room are used for providing care and are accessible to children. During the inspection, there were children sleeping in play yards in inaccessible bedrooms. Previously, Licensee was granted permission to have these rooms accessible only during nap time and only for infants with play yards. Moving forward, Licensee will not use the bedrooms and will be made off-limits and made inaccessible by use of locked doors. There is no swimming pool or other bodies of water on the premises. All firearms and ammunition are stored and locked separately. 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 being barricaded by furniture 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.

Licensee ensures that children in care are supervised at all times. Safe toys and play equipment are observed. 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. Licensee does not provide transportation. 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 07/19/2023. Licensee’s pediatric CPR/First Aid certification expires on 06/2025. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.Continued to LIC809-C

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2024
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 4
Document Has Been Signed on 06/27/2024 05:42 PM - It Cannot Be Edited


Created By: Valerie Mireles On 06/27/2024 at 04:40 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: COLLINS, DENISE
FACILITY NUMBER: 503608001

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPA observation and Licensee interview, child #1 and #2, who are preschool age, were asleep in play yards. This poses a potential risk to the health, safety, or personal rights of children in care.
POC Due Date: 07/12/2024
Plan of Correction
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Licensee will begin using sleep mats for children in care that are over 24 months or have the ability to climb out of the play yard. Licensee will send a photograph of children sleeping on sleep mats by POC date 07/05/2024.
Type B
Section Cited
CCR
102425(j)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, Licensee was not conducting/ documenting 15 minute sleep logs for infants between the age of 12 months and 24 months. This poses a potential risk to the health, safety, or personal rights of children in care.
POC Due Date: 07/12/2024
Plan of Correction
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Licensee was provided with safe sleep resources and information on regulations/requirements. Licensee stated she will complete and document checks by 7/12/2024, and submit proof to CCLD-Fresno Child Care by POC date.
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:Cynthia Brannon
LICENSING EVALUATOR NAME:Valerie Mireles
LICENSING EVALUATOR SIGNATURE:
DATE: 06/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2024


LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 06/27/2024 05:42 PM - It Cannot Be Edited


Created By: Valerie Mireles On 06/27/2024 at 04:40 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: COLLINS, DENISE
FACILITY NUMBER: 503608001

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on review of facility records, the master bedroom, bedrooms 4 and 5 are used for napping infants. According to Licensee, the rooms are inaccessible at all other times. Licensee had preschool age children asleep in play yards in bedroom 5 (child #1) and master bedroom (child #2). Previously, Licensee was granted permission to have these rooms accesible only during naptime only for infants with play yards. This poses a potential risk to the health, safety, or personal rights of children in care.
POC Due Date: 07/12/2024
Plan of Correction
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Licensee will remove play yards from bedrooms and send Licensing a photograph of new placement of sleep mats/ play yards by POC due date of 07/12/2024. Licensee will notify CCL prior to making these rooms accessible to children for inspection purposes.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Cynthia Brannon
LICENSING EVALUATOR NAME:Valerie Mireles
LICENSING EVALUATOR SIGNATURE:
DATE: 06/27/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2024


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: COLLINS, DENISE
FACILITY NUMBER: 503608001
VISIT DATE: 06/27/2024
NARRATIVE
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LPA discussed the Community Care Licensing (CCL) 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. During record review of children’s files, Licensee was not documenting 15 minute sleep logs for infants between the age of 12 months and 24 months. We discussed the CCL 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/.

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.

Exit interview conducted and report was reviewed with licensee Denise Collins. 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, Chapter 3, 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: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2024
LIC809 (FAS) - (06/04)
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