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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503910885
Report Date: 06/09/2021
Date Signed: 06/09/2021 04:07:37 PM

Document Has Been Signed on 06/09/2021 04:07 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:ABALOS, ZENY & CALIMQUIM, RANDY FAMILY CHILD CAREFACILITY NUMBER:
503910885
ADMINISTRATOR:ABALOS,ZENY/CALIMQUIN,RANDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 585-9789
CITY:TURLOCKSTATE: CAZIP CODE:
95380
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
06/09/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Licensee Zeny AbalosTIME COMPLETED:
04:15 PM
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On 06/09/2021, Licensing Program Analyst (LPA), Luisa Gavoutian, conducted an unannounced Annual Inspection. LPA was greeted by Licensee Zeny Abalos who accompanied LPA on a tour of the home, inside and outside, as shown on the facility sketches (LIC 999) provided. Also present were Licensee Randy Caliquim, fingerprint-cleared adult member of the household, and Licensee’s minor child. Present during today’s inspection were eight children. The areas of the home that are accessible to the daycare children are living room, dining room, study room, one bedroom, hallway bathroom, and fenced off portion of the backyard. “Off-limits” rooms are made inaccessible with locks. During today’s inspection, LPA observed the master bedroom and bathroom were accessible to daycare children. Licensee locked the door during the inspection and understands that children are not allowed access.

No pets were observed during today's inspection. There are no bodies of water in this home. Licensee stated there are no firearms in this home. All poisons are kept in a locked storage area. Fireplace is inaccessible to children by shelving built in front of fireplace and will not be in use during daycare hours. There is a working fire extinguisher, which was last serviced on 07/10/2020. LPA tested the smoke detector and carbon monoxide indicator, which were both in working condition. The home has adequate heating and ventilation for safety and comfort. There are no stairs in the home. Safe toys and play equipment were observed.

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. Infants up to 12 months of age are placed on their backs for sleeping. Licensee physically checks on sleeping infants every 15 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 is completed and in file for each infant up to 12 months of age. (Continued on LIC 809-C)
SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE: DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/09/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ABALOS, ZENY & CALIMQUIM, RANDY FAMILY CHILD CARE
FACILITY NUMBER: 503910885
VISIT DATE: 06/09/2021
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There is a working telephone and cellphone number was verified. Adequate supervision is being provided during this inspection. Licensee is aware that children shall not be left in parked vehicles. Children are supervised when outside in the play area. LPA observed that Licensee Randy Caliquim was constructing a large storage unit and stated that it is for the purpose of storing children’s toys and play equipment. Licensees understand that prior to making alterations to the home, the Department must be notified of the proposed changes, per California Code of Regulations (CCR) 102416.3 which states, “(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: (4) Construction of exterior decks or porches.” Car seats are used for transportation purposes only and are not used for sleeping children. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files, which were all complete with emergency information as required. Licensee maintains documentation of immunizations for influenza, pertussis, and measles for herself and staff. Licensee’s Pediatric CPR/First Aid are current expiring on 02/06/2023. Licensees’ Mandated Reporter training certificate was completed on 04/27/2019 and needs to be updated. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advanced notice. Days and hours of operation are Monday – Friday; 7:30 a.m. – 5:30 p.m.

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. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care.

This facility does not provide Incidental Medical Services – IMS. 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 Disabilities 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.
(Continued on LIC 809-C)
SUPERVISORS NAME: Alice Juarez
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
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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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ABALOS, ZENY & CALIMQUIM, RANDY FAMILY CHILD CARE
FACILITY NUMBER: 503910885
VISIT DATE: 06/09/2021
NARRATIVE
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LPA & Licensee discussed the Community Care Licensing (CCL) website (www.ccld.ca.gov) which provides access to Provider Information Notices (PINs), Quarterly Updates, Mandated Reporter Training, Forms, and Regulations. Licensee stated she is receiving PINs and updates through email. LPA discussed infant items permitted in Family Child Care Homes and left a visual handout. LPA provided Licensee with the “Effects of Lead Exposure” brochure in accordance with AB 2370, Chapter 676, Statutes of 2018.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D). Licensee was provided a copy of appeal rights.

Upon receipt of a Type A violation, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

A copy of the Fact Sheet - Child Care Parent Notification Requirements and a copy of LIC 9224 was given to licensee.

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: Alice Juarez
LICENSING EVALUATOR NAME: Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2021
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Document Has Been Signed on 06/09/2021 04:07 PM - It Cannot Be Edited


Created By: Luisa Gavoutian On 06/09/2021 at 02:54 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: ABALOS, ZENY & CALIMQUIM, RANDY FAMILY CHILD CARE
FACILITY NUMBER: 503910885

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/10/2021
Section Cited
CCR
102416.3(a)(6)

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Alterations to Existing Buildings or Grounds; Prior to making alterations... the licensee shall notify the Department of the proposed changed... 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.
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Licensee stated she shall submit a written statement of understanding of reporting requirements in regards to alterations to the building. Licensee locked the master bedroom during today's inspection making it inaccessible.
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This requirement was not met as evidenced by: based on observation, an outdoor storage unit was being constructed and master bedroom was accessible to daycare children as described in LIC 809. This poses an immediate risk to the health, safety, or personal rights of children.
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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:Alice Juarez
LICENSING EVALUATOR NAME:Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2021


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Document Has Been Signed on 06/09/2021 04:07 PM - It Cannot Be Edited


Created By: Luisa Gavoutian On 06/09/2021 at 03:23 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: ABALOS, ZENY & CALIMQUIM, RANDY FAMILY CHILD CARE
FACILITY NUMBER: 503910885

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/23/2021
Section Cited
HSC
1596.8662(b)(1)

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training... and shall complete renewal mandated reporter training every two years following the date on which he
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Licensees agreed to renew the training and submit copies of certificates to CCL by 06/23/2021.
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or she completed the initial mandated reporter training. This requirement was not met as evidenced by: Based on records review, Licensees' failed to renew the mandated reporter trainings. This poses a potential risk to the health, safety, or personal rights of children.
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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:Alice Juarez
LICENSING EVALUATOR NAME:Luisa Gavoutian
LICENSING EVALUATOR SIGNATURE:
DATE: 06/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/09/2021


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