Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045403296
Report Date: 07/31/2017
Date Signed 08/01/2017 02:30:52 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:MONTES, ALMA & ANDREA FAMILY CHILD CARE HOMEFACILITY NUMBER:
045403296
ADMINISTRATOR:MONTES, ALMA & ANDREAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 892-2326
CITY:CHICOSTATE: CAZIP CODE:
95973
CAPACITY:14CENSUS: 8DATE:
07/31/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Alma and Andrea MontesTIME COMPLETED:
04:15 PM
NARRATIVE
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An Annual Random inspection was made to the facility by LPA Laura Chavez. The facility file was reviewed prior to this visit. A review of the Facility Personnel Report Summary indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. Four adults reside in the home. The home and grounds were toured and the licensee was operating within the licensed capacity. Days and hours of operation are Monday - Friday; 6:00am - 5:30pm. The floor and yard plan was verified. Off limit areas in the home are inaccessible to children. The track for the doors for the hallway closet are broken leaving the potential of the doors falling. There is a working telephone in the home. The licensees CPR and First Aid expire 3/12/2018. Immunization records for both licensees were provided indicating immunity against pertussis, measles and influenza. A review of children's records found them in substantial compliance. 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, 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. Items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Poisons are locked in a shed located in the backyard. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the home. The licensee stated there are no firearms and/or other dangerous weapons in the home and none were observed during today's visit. The children use backyard as the outdoor play area. The backyard is completely fenced. There are no bodies of water located on the property. All licensing reports are public information and must be made available upon request for at least three years. A copy of A Child Care Provider's Guide to Safe Sleep was provided during today's visit. This report was reviewed and discussed with licensee Alma Montes.
Notice of Site Visit shall be posted for 30 days from today's visit.

The following Title 22 deficiencies were cited during today's visit. See LIC 809-D.
SUPERVISOR'S NAME: Jordan MonathTELEPHONE: (530) 513-1214
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2017
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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: MONTES, ALMA & ANDREA FAMILY CHILD CARE HOME
FACILITY NUMBER: 045403296
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/31/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/31/2017
Section Cited
102416(c)
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Personnel Requirements. The Licensee and other personnel as specified shall complete training on preventive health practices (PHP) including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
Proof of completing training on PHP not on file.
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The licensees agree to provide proof of having completed training on preventative health practices.

Proof of completion shall be submitted to CCLD on or before 08/31/2017.
Type B
08/31/2017
Section Cited
102417(g)
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Operation of a Family Child Care Home. The home shall be free from defects or conditions which might endanger a child.

The track for the doors for the hallway closet are broken leaving the potential of the doors falling.
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The licensees shall provided proof of having replaced hall closet doors back on track.

Proof of completion shall be submitted to CCLD on or before 08/31/2017.
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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: Jordan MonathTELEPHONE: (530) 513-1214
LICENSING EVALUATOR NAME: Laura ChavezTELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:

DATE: 07/31/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2017
LIC809 (FAS) - (06/04)
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