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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911679
Report Date: 11/22/2021
Date Signed: 11/22/2021 03:35:24 PM

Document Has Been Signed on 11/22/2021 03:35 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:AYALA, MARICELA FAMILY CHILD CAREFACILITY NUMBER:
153911679
ADMINISTRATOR:AYALA, MARICELAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 300-0006
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93307
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/22/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Maricela AyalaTIME COMPLETED:
03:45 PM
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Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On November 22, 2021, Licensing Program Analyst (LPA), Norma Lomeli met with Spanish-speaking Applicant, Maricela Ayala for a pre-licensing/ change of location inspection. Applicant and one minor child reside in the home. Background clearances are discussed and LIS 531 is signed indicating that the adults currently living in the home and/or providing care and supervision to children have a criminal record clearance.

Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed:
  • This is a single story, five bedrooms and two bathrooms home and children will have access to the living room, dining room, kitchen, bedroom #4 (day care room), and hallway bathroom. Off-limits rooms are made inaccessible by the use of a child proof safety gate, a chain lock and plastic door knob covers. Cabinets are made inaccessible by the use of magnetic child proof safety locks.
  • There is no fireplace in the home.
  • LPA observed children size furniture and two high chairs in the dining room. There is a parents board on the left hand side of the home's entry way. Also observed in bedroom #4 (day care room), a crib, children cubbies, safe toys and books for the day care children. Children will nap in bedroom #4 on mats and cots. Infants will nap in play yards or a crib. Applicant understands she is to supervise children at all times. LPA provided applicant with Individual Sleeping Plan and Safe Sleep handout.
  • Facility has 2A10BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2021
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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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: AYALA, MARICELA FAMILY CHILD CARE
FACILITY NUMBER: 153911679
VISIT DATE: 11/22/2021
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  • Applicant’s Pediatric CPR and First Aid certification was completed through Pediatric Plus with Emergency Medical Services Authority stickers (EMSA) and expires on October 25, 2023.
  • Preventative Health and Safety with Prevention of Lead exposure certification was completed on August 21, 2020.
  • Knives are stored in a plastic container inside a top kitchen cabinet. Medications are stored in the inaccessible office. Cleaning compounds are stored inside the inaccessible garage.
  • Advised applicant fire drills are to be conducted once every 6 months and must be documented with date and time. A fire drill log was provided as an example.
  • Applicant is advised at least one staff member with current training in pediatric first aid and pediatric CPR is to be on site at all times children are present.
  • There are no bodies of water in the home or premises.
  • Applicant states there are 11 turtles in the home that are temporarily kept in the garage but will be inaccessible to the day care children.
  • Applicant states there are no firearms, ammunition or poisons in the home or premises.
  • Applicant is reminded that any advertising (of day-care) such as business cards, flyers/posters, and/or signs must include facility number as per Title 22 Regulation "Advertisements and License Number" 102359 (a).
  • Applicant is advised that smoking is prohibited on the premises of a family child care home as specified in Health and Safety Code Section 1596.795(a). Applicant states the home is smoke-free.
  • Applicant states she will be transporting day care children. Applicant understands that she must have proper car restraints and/or car seats for all the children under her care when transporting children.
  • Fenced backyard will be inaccessible to the day care children. Applicant states that she will ensure that the glass sliding door is kept locked during day care hours. The backyard is an empty lot with dirt, applicant states that she is going to have an area cemented and sodded in the future. Applicant understands that any modifications to her home need to be discussed with her analyst. The analyst will have to conduct an inspection before day care children are allowed to have access to the backyard.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021
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: AYALA, MARICELA FAMILY CHILD CARE
FACILITY NUMBER: 153911679
VISIT DATE: 11/22/2021
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  • Applicant completed the Mandated Reporter Training on February 8, 2020.
  • SB 792 immunizations verified and on file..
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given to applicant.
  • Incidental Medical Services (IMS) policy was discussed. 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.

Required postings, forms packet, which included Parent Notification Requirement and LIC9224 were provided and discussed in detail. Applicant is advised that she may access CCLD website at www.ccld.ca.gov for additional forms and licensing updates. She is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Saturday from 4:00 AM to 5:00 PM and as arranged. No overnight care will be provided.

LPA & applicant discussed the Community Care Licensing website: LPA and applicant discussed new additions to the website that include the new PIN (Provider Information Notification) and information for providers including the Quarterly Update that informs licensees of new legislation and regulations. Please follow these steps go to http://www.cdss.ca.gov/, click on “information and resources” click “Community Care Licensing” Click “quarterly updates” click “Child Care advocates program” and register to PIN.



Licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended effective November 23, 2021.   

Applicant is pending a Large Family Day Care Home license. LPA will conduct a capacity increase inspection when the department receives the granted Fire Inspection Request (STD850).
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2021
LIC809 (FAS) - (06/04)
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