Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 543910503
Report Date: 11/18/2019
Date Signed: 11/19/2019 10:12:03 AM

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:MCPHETRIDGE, CONCEPCION FAMILY CHILD CAREFACILITY NUMBER:
543910503
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 3DATE:
11/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Concepcion McPhetridgeTIME COMPLETED:
01:45 PM
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On this date, Licensing Program Analyst (LPA) Kathy Pacheco conducted an unannounced annual/random inspection. LPA met with Licensee, Concepcion McPhetridge, who provided a tour of the home, inside and outside, as shown on the facility sketch. There were no "bodies of water" in this facility. Firearms and ammunition were properly stored. Poisons, cleaning compounds, medications and other hazardous items were inaccessible to children. The fireplace is not in use during day care hours. The fire extinguishers, smoke detectors, and carbon monoxide indicator met Community Care Licensing (CCL) regulations. The home was kept clean and orderly, with heating and ventilation for safety and comfort. The stairs were barricaded with children under five years old present. Safe toys and play equipment were observed. There was one small dog at the home that does not have access to the day care children. Licensee understands the liability of pets around day care children and accepts responsibilities of any action taken by pets. Licensee had a working telephone and the above telephone number was verified. Adequate supervision was being provided during this inspection. Outdoor play areas were fenced or supervised by the Licensee or care giver. Capacity as specified on the license was being maintained. Children’s records contained all emergency information specified by regulation. There were no excluded individuals present at this home. All adults who reside or work in the home had a criminal record clearance or exemption as indicated on LIS 531 – Facility Personnel Report Summary. The Licensee and other personnel as specified completed training on preventative health practices including pediatric CPR and first aid; Expires: 8/18/20. Licensee provided proof of required Mandated Reporter Training; Completed: 8/10/18.

Incidental Medical Services (IMS) policy was discussed. Licensee was aware that an IMS plan is required to be submitted to the Licensing office if they provide any of these services.

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SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
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: MCPHETRIDGE, CONCEPCION FAMILY CHILD CARE
FACILITY NUMBER: 543910503
VISIT DATE: 11/18/2019
NARRATIVE
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LPA provided Licensee with information regarding the California Department of Social Services (CDSS) Provider Information Notices (PINs) communication system; information regarding Safe Sleep Regulations; AB 2370, Chapter 676, Statutes of 2018, requiring child care providers to inform parents and/or guardians with lead safety information, and other important resources and information links offered on the CDSS website.

Business hours are Monday through Friday 7:00 AM to 5:00 PM and other hours as arranged.

Per Title 22 of the California Code of Regulations no deficiencies were observed today.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.
SUPERVISOR'S NAME: Michael DuarteTELEPHONE: (559) 650-7874
LICENSING EVALUATOR NAME: Kathy PachecoTELEPHONE: (559) 341-5116
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2019
LIC809 (FAS) - (06/04)
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