103906918-4-13-2023-57-CC-ROCA-CQUQK5-20230413121346

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103906918
Report Date: 04/13/2023
Date Signed: 04/13/2023 12:14:12 PM

Document Has Been Signed on 04/13/2023 12:14 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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	VAZQUEZ, ANGELINA FCC		FACILITY NUMBER:	103906918
ADMINISTRATOR:	VAZQUEZ, ANGELINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 257-7782
CITY:	SELMA	STATE: CA	ZIP CODE:	93662
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 2	DATE:	04/13/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Angelina Vazquez		TIME COMPLETED:	12:30 PM

NARRATIVE

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On 4/13/2023, Licensing Program Analysts (LPAs) Ruby Ocegueda and Paul Garcia conducted an unannounced Annual Required Inspection and was met by Licensee, Angelina Vazquez. Licensee is Spanish Speaking and LPA Ocegueda provided services in Spanish. Days and hours of operation are Monday to Friday 5:00 AM to 5:00 PM.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed, and Licensee confirmed that the kitchen, one hall bathroom and living room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of doorknob safety covers. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. Licensee stated that the poisons were in the garage but were not locked. The door to the garage had a child safety door knob safety spinner. Inside a living room cabinet, LPA’s observed three small bottles of hand sanitizer, eye glass cleaner that had “keep out of reach of children” warning and also prescription eye drops. Licensee confirmed the observation and removed the items to inaccessible areas. Licensee also had accessible hand sanitizer near the door. In an accessible kitchen drawer, there was an insect bait. Licensee removed the bait.

There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is 559-257-7782.

LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan was discussed and provided to licensee. Infants up to 12 months of age are placed on their backs for sleeping. Report continued to 809-C.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

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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Document Has Been Signed on 04/13/2023 12:14 PM - It Cannot Be Edited

Created By: Ruby Ocegueda On 04/13/2023 at 11:08 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: VAZQUEZ, ANGELINA FCC	FACILITY NUMBER: 103906918
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102423(a)(2)

Personal Rights

(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above in. LPA's Ocegueda and Garcia observed rusted rods holding up fence that was recently fallen over from storms. LPA's observed a bucket with mop water outside of the sliding glass door leading to the accessible play yard. LPA's obverted multiple tree roots protruding in the play yard causing tripping hazards. Licensee stated her poisons were unlocked in the accessible garage. In the kitchen, there was one insect bait inside a accessible drawer. There was two outlets with no safety guards in the play yard. In the living room, there was a cabinet with hand sanitizer and eye drops. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/27/2023
	Plan of Correction
1 2 3 4	Licensee dumped out the water from the bucket and removed the items that were inside the cabinet in the living room. Licensee removed the insect bait from the kitchen drawer. Licensee stated she would be making her yard off limits for the time being until the fence was permanently repaired and the roots were removed. Licensee will be locking the poisons in the garage. Licensee will send photos of locked poisons and covered outlets outside in the play yard. Licensee will send proof of corrections by POC date 4/27/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Susie Fanning

LICENSING EVALUATOR NAME:

Ruby Ocegueda

LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

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
FRESNO SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: VAZQUEZ, ANGELINA FCC	FACILITY NUMBER: 103906918
	VISIT DATE: 04/13/2023

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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and was inspected. Per licensee, her fence recently fell over with the winter storm and is currently being held up with metal rods. Some of the rods are rusted. There are also several tree roots that are protruding. Directly outside the sliding glass door leading to the play yard was a bucket with a mop and mop water. Licensee immediately dumped the mop water. Also observed outside were two outlets that did not have safety covers. As of today, the back play yard will be "off limits" and licensee stated she would only use the front yard for outside play time. Licensee understands that complete supervision will be required in the unfenced front yard. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was expired as of 1/1/2023. Licensee’s pediatric CPR/First Aid expires on 3/2024. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

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.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

LPA Ocegueda conducted an exit interview with licensee Angelina Vazquez. This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023

LIC809 (FAS) - (06/04)

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