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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543911780
Report Date: NO Visit Data Available
Date Signed: 06/03/2022 09:24:47 AM

Document Has Been Signed on 06/03/2022 09:24 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:MAGANA, IRIS FAMILY CHILD CAREFACILITY NUMBER:
543911780
ADMINISTRATOR:MAGANA, IRISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 218-5157
CITY:TERRA BELLASTATE: CAZIP CODE:
93270
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
MET WITH:Iris MaganaTIME COMPLETED:
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Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On June 2, 2022, Licensing Program Analysts (LPAs), Norma Lomeli and Diane Mercado met with Spanish-speaking Applicant, Iris Magana for a pre-licensing inspection. Applicant, her husband, her adult son, her adult daughter-in-law, her sister-in-law 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 or exemption. Fire clearance was granted on May 19, 2022.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • Fire clearance was received on May 27, 2022. Fire alarm is located in the day care room on the right hand side of the wall.
  • This is a single story, five bedrooms, four bathrooms and a fitness room (day care room) home and children will have access to the day care room and bathroom that is located in the backyard patio area. Off-limits rooms are made inaccessible by use of plastic door knob covers. The day care entrance will be through the left hand side run towards the back of the home.
  • There is a fireplace in the living room that applicant states it will not be used during day-care hours and will not be accessible to the day car children.

(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE:
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE:
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: MAGANA, IRIS FAMILY CHILD CARE
FACILITY NUMBER: 543911780
VISIT DATE: 06/02/2022
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  • 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.
  • Unfenced backyard has a cemented and artificial turf area for the day care children.
  • SB 792 immunizations verified and on file.
  • Applicant completed the Mandated Reporter Training on October 14, 2020. Applicant’s Assistant completed the training on February 11, 2022.
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
  • Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. 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.

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. Applicant is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday from 6:00am to 6:00pm 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.


(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022
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: MAGANA, IRIS FAMILY CHILD CARE
FACILITY NUMBER: 543911780
VISIT DATE: 06/02/2022
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  • LPA observed in the day care room; children size furniture, children cubbies, safe toys and books for the children. There is a parents board on the right hand side of the day care room wall. There is a white board, an infant swing, three high chairs, a diaper changing station and arts and craft supplies. Children will nap in the day care room on cots or mats. Infants will nap in cribs. 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.
  • Applicant’s Pediatric CPR and First Aid certification was completed through EMS Safety and expires on February 9, 2024. Applicant’s Assistant, Marco Antonio Magana completed the training through EMS Safety and expires on February 20, 2024.
  • Preventative Health and Safety with Prevention of Lead exposure certification was completed on September 25, 2021.
  • Knives are stored in the inaccessible kitchen. Medications are stored in an inaccessible bedroom. Cleaning compounds are stored in the garage.
  • 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 are no bodies of water in the home or premises.
  • There is one dog and three cats that are kept indoor/outdoor and will be accessible to the day care children. There are ten birds kept inside a cage inaccessible to the day care children. 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. Poisons are kept in the detached garage that is kept under key lock.
  • 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).
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022
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: MAGANA, IRIS FAMILY CHILD CARE
FACILITY NUMBER: 543911780
VISIT DATE: 06/02/2022
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Applicant is advised the following items must be corrected and documentation be sent to Fresno CCL within the next 60 days to avoid possible withdraw.
  • Applicant will obtain fingerprints clearances and/or exemptions for four adults who reside in the home.
  • Applicant will make inaccessible a pile of wood, ladders, a trampoline and other potential hazardous items that are located in the unfenced back yard.

Pending verification of corrections of the above items and a final review of her application, licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022
LIC809 (FAS) - (06/04)
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