543911644-1-21-2022-04-CC-NLOI-CAVT2T-20220121132115

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543911644
Report Date: 01/21/2022
Date Signed: 01/21/2022 01:21:27 PM

Document Has Been Signed on 01/21/2022 01:21 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:	GOMEZ ARAUJO, BERNARDINA FAMILY CHILD CARE		FACILITY NUMBER:	543911644
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	01/21/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Bernardina Gomez Araujo		TIME COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On January 21, 2022, Licensing Program Analyst (LPA), Norma Lomeli met with Spanish-speaking Applicant, Bernardina Gomez Araujo for a pre-licensing inspection. Applicant, her husband, and one minor child reside in the home. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: This is a single story, three bedrooms and two bathrooms home and children will have access to the living room, bedroom #3 (day care room), kitchen/dining room and hallway bathroom. Off-limits rooms are made inaccessible by use of child proof safety gate and plastic door knob covers. There is no fireplace in the home. LPA observed children size furniture and safe toys for the day care children. Children will nap in the living room on mats. Infants will nap in a play yard or a crib. The crib has a diaper changing table. There is a flat screen television on top of a wooden television cabinet. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout. Facility has 2A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place. (Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022

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: GOMEZ ARAUJO, BERNARDINA FAMILY CHILD CARE	FACILITY NUMBER: 543911644
	VISIT DATE: 01/21/2022

NARRATIVE

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SB 792 immunizations verified and on file.
Applicant completed the Mandated Reporter Training on August 9, 2021.
LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. She is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Saturday from 4:00 AM to 6:00 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.

Applicant is advised the following items must be corrected and documentation be sent to Fresno CCL within the next 30 days to avoid possible withdraw.

Applicant will make the PG&E meter that is located on the side run of the home inaccessible to the day care children.
Applicant will make the door that leads to the garage from the dining room inaccessible to the day care children.

Pending verification of corrections of the above items and a final review of her application, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022

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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GOMEZ ARAUJO, BERNARDINA FAMILY CHILD CARE	FACILITY NUMBER: 543911644
	VISIT DATE: 01/21/2022

NARRATIVE

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Applicant’s Pediatric CPR and First Aid certification was completed through American Red Cross and expires on August 21, 2023.
Preventative Health and Safety with Prevention of Lead exposure certification was completed on August 19, 2021.
Knives and medications are stored inside top kitchen cabinets inaccessible to the day care children. Cleaning compounds are stored inside a hallway closet on a top shelf, the closet is made inaccessible by the use of a plastic door knob cover.
Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
There is an in-ground pool that is fenced with black rod iron fencing in accordance with Title 22 Regulations. The gate is self-latching/self-closing, swings away from the pool and latching device is located no more than six inches from the top of the gate.
There are two dogs and a cat that are kept inside a kennel that is located in the gated pool area. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
Applicant states there are no firearms or ammunition in the home or premises. Poisons are kept locked area that is located in the gated pool area.
Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
Applicant states she will be transporting day care children. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.
Fenced backyard has a cemented and sodded area for the day care children to play. There is patio furniture and a patio porch.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2022

LIC809 (FAS) - (06/04)

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