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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543909322
Report Date: 01/19/2022
Date Signed: 01/19/2022 10:14:03 AM

Document Has Been Signed on 01/19/2022 10:14 AM - 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:PEREZ, AMPARO FAMILY CHILD CAREFACILITY NUMBER:
543909322
ADMINISTRATOR:PEREZ, AMPAROFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 350-9730
CITY:PORTERVILLESTATE: CAZIP CODE:
93257
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Amparo Perez, LicenseeTIME COMPLETED:
10:30 AM
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On 01/19/2022, Licensing Program Analyst (LPA), Pete Espinoza, conducted an unannounced Required 1-Year Inspection. LPA was greeted by Amparo Perez, Licensee who accompanied LPA on a tour of the home, inside and outside, as shown on the facility sketch. Licensee is Spanish Speaking. Licensee stated she has not cared for children since July, 2021
The areas of the home that are accessible to the day-care children are the kitchen and dining area, living room and hallway bathroom. “Off-limits” rooms are made inaccessible by doorknob spinners.
There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medications and other hazardous items are inaccessible to children. There are no fireplaces or open face heaters in the home. The fireplace located in the living room is made inaccessible by a screen and will not be in use during day-care hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment were observed.
LPA discussed the 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-and-resources/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.
LPA observed accorded safe, healthful, and comfortable accommodations, furnishings, and equipment. Children will be supervised when outside in the play area and there are no hazards to children present.
(Continued on LIC 809-C)
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Peter Espinoza
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2022
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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: PEREZ, AMPARO FAMILY CHILD CARE
FACILITY NUMBER: 543909322
VISIT DATE: 01/19/2022
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There is a working telephone and cellphone number was verified. There are no children currently enrolled, therefore, no children's files to review. Licensee maintains documentation of immunizations for influenza, pertussis, and measles for herself and staff. Licensee’s Pediatric CPR/First Aid are current expiring on 12/29/2023. Licensee’s Mandated Reporter training certificate was completed on 04/13/2019. 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.
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Incidental Medical Services (IMS) are not currently being provided. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm
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, no deficiencies were cited. Exit interview conducted and report was reviewed with the Amparo Perez, Licensee.
A notice of site visit was given and must remain posted for 30 days.
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.
SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Peter Espinoza
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2022
LIC809 (FAS) - (06/04)
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