Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103908175
Report Date: 07/17/2018
Date Signed: 07/18/2018 09:18:36 PM

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:SANDOVAL, AIDEE FAMILY CHILD CAREFACILITY NUMBER:
103908175
ADMINISTRATOR:SANDOVAL, AIDEEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 846-3616
CITY:KERMANSTATE: CAZIP CODE:
93630
CAPACITY:14CENSUS: 7DATE:
07/17/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Aidee SandovalTIME COMPLETED:
01:30 PM
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(3) "Spanish speaker" Licensing Program Analyst (LPA) Diana Martinez conducted an unannounced annual/random inspection. LPA met with licensee Aidee Sandoval. Also present were licensee’s husband/assistant Francisco Sandoval, daughter/assistant Daisy Sandoval, daughter Elizabeth Sandoval and son-in-law Christopher Rodriguez who reside in the home. Seven children were present today. LPA conducted an interior and exterior tour of the home. The accessible rooms are the living room, dining room and hall bathroom. The off-limit rooms are made inaccessible with child safety plastic door knob covers and a child safety gate placed at kitchen entry. Safe, healthful, and comfortable accommodations, furnishings, and equipment were observed. Also observed were safe toys, play equipment, and materials. Licensee does not have any pets. Observed a plastic play structure in the back yard. There are no bodies of water or firearms in this home. No poisons were observed on the premises. Cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace in living room is inaccessible to children. Fireplace is not used during day care hours. There is a working fire extinguisher, smoke detector, carbon monoxide indicator, and adequate heating and ventilation for safety and comfort. There are no stairs in the home. There is a working cellular telephone and number was verified. Adequate supervision is being provided during this visit. Capacity as specified on the license is being maintained. A current roster of the children in care is maintained. Licensee maintains documentation of immunizations for the children. Licensee maintains documentation of immunizations against pertussis and measles for herself and two assistants and all three opted out of influenza immunization. Pediatric CPR/First Aid are current with the expiration date of 1/2019.

LPA discussed Incidental Medical Services (IMS) policy and provided handout Plan for Providing Incidental Medical Services (IMS) – FCCH Requirements. 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 (USDOJ) 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. (See next page)

SUPERVISOR'S NAME: Valarie ReedTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Diana D MartinezTELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2018
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: SANDOVAL, AIDEE FAMILY CHILD CARE
FACILITY NUMBER: 103908175
VISIT DATE: 07/17/2018
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Licensee has provided parents with a copy of the Family Child Care Home Notification of Parent's Rights (LIC 995A). Fire drills are conducted and documented with the date and time every month. Licensee is aware that children are never to be left in parked vehicles. 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. Licensee is aware that upon notice from the Department, any excluded individual must be immediately removed from the home and prevented from returning to the home or having contact with children in care. Licensee is aware that any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice.

Days and hours of operation are Monday – Friday from 5:00 AM – 5:00 PM.

LPA reviewed and provided information to licensee regarding prohibited infant equipment and safe sleep.



Per California Code of Regulations, Title 22, Division 12, Chapter 3, no deficiencies cited during today's visit.

An exit interview conducted with licensee Aidee Sandoval and a copy of this report was provided and discussed. A Notice of Site Visit Form (LIC 9213) was posted on parent's board and must remain posted for 30 days.
SUPERVISOR'S NAME: Valarie ReedTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Diana D MartinezTELEPHONE: (559) 341-4670
LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2018
LIC809 (FAS) - (06/04)
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