243911594-8-24-2021-04-CC-NLOI-C67RS8-20210824131619

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243911594
Report Date: 08/13/2021
Date Signed: 08/24/2021 01:16:33 PM

Document Has Been Signed on 08/24/2021 01:16 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:	ESTRADA, ERIKA FAMILY CHILD CARE		FACILITY NUMBER:	243911594
ADMINISTRATOR:	ESTRADA, ERIKA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 564-7525
CITY:	LOS BANOS	STATE: CA	ZIP CODE:	93635
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	08/13/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Erika Estrada		TIME COMPLETED:	11:00 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Prior to today's inspection, LPA telephoned call applicant and conducted the COVID-19 Emergency Response Tele-Inspection Screening Process. On August 13, 2021, Licensing Program Analyst (LPA), Norma Lomeli met with Applicant, Erika Estrada for a pre-licensing/change of location inspection. Applicant and her minor child reside in the home. Verified applicant’s CPR and First Aid was completed through Pediatric Plus with Emergency Medical Services Authority stickers (EMSA) and expires on July 17, 2021. Applicant’s Assistant, Josefina Galvan who completed the training through American Heart Association and expires on July 26, 2023. 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. Fire clearance was granted on August 9, 2021. Facility was inspected inside and outside as shown on the facility sketch and the following items were discussed: Fire clearance was received on August 13, 2021. Licensee states that fire inspector did not require for her to install a fire pull alarm. This is a two story, five bedrooms and three bathrooms home and the main part of the home including upstairs area will be off-limits to the day-care children. There is detached building that is located on the side of the home. Care and supervision will be provided in detached building that has heating and ventilation in the day care room, a bathroom and an office. The day care room and bathroom will be the only areas accessible to the day care children. The office is made inaccessible by the use of a child proof plastic door knob cover. There is a fireplace in the family room that applicant states it will not be used during day-care hours. (Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021

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: ESTRADA, ERIKA FAMILY CHILD CARE	FACILITY NUMBER: 243911594
	VISIT DATE: 08/13/2021

NARRATIVE

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LPA observed children size furniture, safe toys, and books for the children. Children will nap in the day care room. Applicant understands she is to supervise children at all times.
The day care room has 3A40BC fire extinguisher, smoke alarm, carbon monoxide alarm and first aid kit in place.
Preventative Health and Safety class was completed on July 29, 2021.
Knives, medications and cleaning compounds are stored in the main part of the home that will be inaccessible to the day care children.
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 is an in-ground ground pool that is not fenced in accordance with Title 22 Regulations. The gate is not self-latching/self-closing and does not swing away from the pool.
Applicant states there are no pets in the home or on the premises. Applicant is advised it is her responsibility to ensure the safety of children in care at all times from the pets.
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 restraints and/or car seats for all the children under her care when transporting children.
Fenced backyard has an area with artificial grass. LPA observed children size table and chairs, safe toys and a Little Tikes play house for the day care children. There is a sink in the backyard accessible to the day care children.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021

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: ESTRADA, ERIKA FAMILY CHILD CARE	FACILITY NUMBER: 243911594
	VISIT DATE: 08/13/2021

NARRATIVE

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SB 792 immunizations verified and on file.
Applicant completed the Mandated Reporter Training on March 21, 2021. Applicant’s assistant completed the training on June 27, 2019. Applicant will update her Mandated Reporter Training certification.
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 Friday from 9:00 AM to 6:00 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.

Applicant is advised the following items must be corrected and documentation be sent to CCL within the next 30 days to avoid possible withdraw.

(Continued on LIC809-C):

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021

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: ESTRADA, ERIKA FAMILY CHILD CARE	FACILITY NUMBER: 243911594
	VISIT DATE: 08/13/2021

NARRATIVE

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Applicant will make the in-ground pool inaccessible to the day care children. LPA observed that the side area of the in-ground pool is fenced with wooden board fencing that obscures the view from pool. LPA observed windows and doors from the home that have direct access to the pool. LPA provided applicant with Title 22 Regulation for bodies of water.
Applicant's Assistant will provide proof of the Mandated Reporter Training certification.

Pending verification of corrections of the above items and a final review of her application, licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended.

SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021

LIC809 (FAS) - (06/04)

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