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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910605
Report Date: 03/16/2022
Date Signed: 03/16/2022 12:40:32 PM

Document Has Been Signed on 03/16/2022 12:40 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:SALGADO, MARTHA FAMILY CHILD CAREFACILITY NUMBER:
153910605
ADMINISTRATOR:SALGADO, MARTHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
5593097288
CITY:WASCOSTATE: CAZIP CODE:
93280
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
03/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Martha Salgado TIME COMPLETED:
12:55 PM
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On 03/16/22 Licensing Program Analyst (LPA), Araceli Gibson conducted an unannounced One Year Required Inspection and was met by Licensee, Martha Salgado. Days and hours of operation are Monday through Saturday 5:00 AM to 5:00 PM.

LPA toured the home inside and outside and a census was taken of 5 children in care. Licensee confirmed that the living room, dining room, kitchen, bathroom, and back yard are used for providing care and is accessible to children. All other rooms are off-limits and made inaccessible by use and spinner knobs and safety gates. There is no swimming pool or other bodies of water on the premises. No firearms on the premises. No poison, detergents, cleaning compounds, or other hazardous items were observed in today’s inspection.

There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs or a fireplace in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559) 309-7288.

There is one infant over 12 months in care. LPA discussed Safe Sleep Regulations with licensee. Licensee is aware there is to be one crib or play yard for each infant in care if Licensee decides to enroll more infants. 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. Infants up to 12 months of age are placed on their backs for sleeping. Licensee understands the use of the Infant Sleep LIC9227 form.

Continue 809C

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE: DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/16/2022
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: SALGADO, MARTHA FAMILY CHILD CARE
FACILITY NUMBER: 153910605
VISIT DATE: 03/16/2022
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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. Outdoor areas are clean and safe for children to use. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with the immunizations. Licensee completed the General Mandated Reporter Training on 01/21/22. Licensees’ pediatric CPR/First Aid expires on 10/2022. 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, No deficiencies are being cited during today’s visit.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Araceli Gibson
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
LIC809 (FAS) - (06/04)
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