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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910036
Report Date: 06/03/2021
Date Signed: 06/03/2021 12:23:20 PM

Document Has Been Signed on 06/03/2021 12:23 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MORRIS-MOSSMAN, CANDICE FAMILY CHILD CAREFACILITY NUMBER:
153910036
ADMINISTRATOR:MORRIS-MOSSMAN, CANDICEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 487-6623
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93304
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 10DATE:
06/03/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Candice Morris-MossmanTIME COMPLETED:
12:30 PM
NARRATIVE
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On Thursday, 06/03/21, Licensing Program Analysts (LPAs) Araceli Gibson and Rene Mancinas conducted an unannounced case management inspection. LPAs met with Licensee, Candice Morris-Mossman.

During inspection regarding an unrelated incident, LPAs observed adult #1 walk into the facility with three children. When Licensee was asked by LPAs to confirm who adult #1 was, Licensee stated she was a friend, who was in the process of obtaining fingerprint clearance to assist at the day care. LPA Mancinas then asked Adult #1 a series of questions regarding her presence at the facility. Adult #1 stated she was offered a job by Licensee and has assisted with caring for day care children for at least a month.

Due to the above information obtained through statements and observations, the following deficiency is being cited (See 809-D for further). A civil penalty is also being assessed. Appeal rights were provided.

Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. Licensee must have all parents of enrolled children sign the Acknowledgement of Receipt of Licensing Reports and must retain a copy in each child’s file.

Notice of Site Inspection to be posted for 30 days. Exit interview conducted with Candice.
SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE: DATE: 06/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/03/2021
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 06/03/2021 12:23 PM - It Cannot Be Edited


Created By: Araceli Gibson On 06/03/2021 at 11:59 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: MORRIS-MOSSMAN, CANDICE FAMILY CHILD CARE
FACILITY NUMBER: 153910036

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/03/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
06/04/2021
Section Cited
CCR
102370(d)(1)

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All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Department.
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Adult #1 left the facility immediately. Licensee stated she will ask adult #1 to submit fingerprint clearances by 06/04/2021. Proof to be submited.
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This requirement was not met as evidenced by inspection observations and statemetns. (See 809 for further) This is an immediate risk to the health, safety, and personal rights of children in care.
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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:Susie Fanning
LICENSING EVALUATOR NAME:Araceli Gibson
LICENSING EVALUATOR SIGNATURE:
DATE: 06/03/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/03/2021


LIC809 (FAS) - (06/04)
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