543911232-6-3-2021-04-CC-JTHN-C3MRAK-20210603125116

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543911232
Report Date: 06/03/2021
Date Signed: 06/03/2021 12:51:22 PM

Document Has Been Signed on 06/03/2021 12:51 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:	MORENO, CECILIA FAMILY CHILD CARE		FACILITY NUMBER:	543911232
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 11	DATE:	06/03/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Cecilia Moreno- Licensee		TIME COMPLETED:	01:00 PM

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On 6/03/2021 Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced Annual Required Inspection. LPA met with Licensee Cecilia Moreno. Also present was Licensee’s Assistant, Jose Moreno. Days and hours of operation are 7:00 AM-5:30 PM, Monday through Friday.

LPA toured the home inside and outside and a census was taken. Current facility sketch was reviewed and Licensee confirmed that the kitchen, both downstairs bathrooms, bedroom #1, and both living room areas are used for providing care and are accessible to children; all other rooms are off-limits and made inaccessible by use of a baby gate. There is no swimming pool or other bodies of water on the premises. 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 a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Stairs are fenced or barricaded when children under age five years old are present. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559)212-0225.

LPA discussed Safe Sleep Regulations with Licensee. 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 can be visually observed through an open door if sleeping in a separate room.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

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.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required.

SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Jessika Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

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: MORENO, CECILIA FAMILY CHILD CARE	FACILITY NUMBER: 543911232
	VISIT DATE: 06/03/2021

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Licensee’s Mandated Reporter Training was completed on 1/30/2020. Licensee’s pediatric CPR/First Aid expires on 2/11/2022. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

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.

Incidental Medical Services (IMS) are currently being provided. 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 Disability 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.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit was provided and is required to be posted for 30 days

SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Jessika Thompson
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

LIC809 (FAS) - (06/04)

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