543911572-12-5-2022-57-CC-ROCA-CLTRV3-20221205122053

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543911572
Report Date: 12/05/2022
Date Signed: 12/05/2022 12:22:03 PM

Document Has Been Signed on 12/05/2022 12:22 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	REYES, ANNA FAMILY CHILD CARE		FACILITY NUMBER:	543911572
ADMINISTRATOR:	REYES, ANNA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 306-9787
CITY:	PORTERVILLE	STATE: CA	ZIP CODE:	93257
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 4	DATE:	12/05/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Anna Reyes		TIME COMPLETED:	12:40 PM

NARRATIVE

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On 12/5/2022, Licensing Program Analyst (LPA) Ruby Ocegueda, conducted an unannounced Annual Required Inspection and was met by Licensee, Anna Reyes. Days and hours of operation are Monday through Friday from 5:30 AM to 5:30 PM or other hours as arranged.

LPA toured the home inside and outside and a census was taken. There were two day care children in care today. Current facility sketch reviewed, and Licensee confirmed that the kitchen, one hall bathroom, living room and bedroom #1 and bedroom #2 are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of doorknob safety covers. 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, medication and other hazardous items are made inaccessible.

The fireplace located in the living room is made inaccessible by a baby gate 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. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559) 306-9787.

LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care. LPA reminded licensee that cribs and play yards should be 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. Report continued to 809-C

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2022

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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Document Has Been Signed on 12/05/2022 12:22 PM - It Cannot Be Edited

Created By: Ruby Ocegueda On 12/05/2022 at 11:41 AM

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: REYES, ANNA FAMILY CHILD CARE	FACILITY NUMBER: 543911572
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(4)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, licensee did not comply with the section cited above. Licensing Program Analyst (LPA) Ocegueda observed two lawn mowers, an edger and a leaf blower in the play yard. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/19/2022
	Plan of Correction
1 2 3 4	Licensee stated she would remove the items named above in the off limits garage and maintain her yard and home safe from any hazardous items. Licensee will send proof to the Department by POC date 12/19/2022.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Susie Fanning

LICENSING EVALUATOR NAME:

Ruby Ocegueda

LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2022

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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: REYES, ANNA FAMILY CHILD CARE	FACILITY NUMBER: 543911572
	VISIT DATE: 12/05/2022

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Provider physically checks on sleeping infants every fifteen minutes and was reminded to document 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. Infants up to 12 months of age are placed on their backs for sleeping.

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 was inspected. In the back yard, LPA observed two lawn mowers, an edger and a leaf blower. Licensee requested to make the yard off limits today as she is not currently using it. Licensee maintains the sliding door locked and on other occasions has used a door stopper. 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. Licensee’s Mandated Reporter Training was completed on 5/2/2022. Licensee’s pediatric CPR/First Aid expires on 5/20/2023. A review of records was completed for licensee and staff #2. Staff #2 was missing proof of immunization's today and other licensing forms. LPA provided licensee a list of all documents that should be in staff files at all times.

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 not 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, the following deficiency was cited, see 809-D. Appeal Rights were provided.

An exit interview was conducted with licensee Anna Reyes. 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: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2022

LIC809 (FAS) - (06/04)

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