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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503907875
Report Date: 08/20/2024
Date Signed: 08/20/2024 03:35:17 PM

Document Has Been Signed on 08/20/2024 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:ESTRADA, ANA FAMILY CHILD CAREFACILITY NUMBER:
503907875
ADMINISTRATOR/
DIRECTOR:
ESTRADA, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 595-8504
CITY:NEWMANSTATE: CAZIP CODE:
95360
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
08/20/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Ana Estrada, LicenseeTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On 08/20/2024, Licensing Program Analyst (LPA) Ka Vang conducted an unannounced Annual Random Inspection and was met by Licensee Ana Estrada. Days and hours of operation are Monday through Friday, from 7:00 a.m. to 5:30 p.m. The home has a working telephone service and LPA confirmed the phone number is (209) 595-8504. Licensee stated that she provides meals to the children in care.

LPA toured the home inside and outside. Census was taken and there are three daycare children present. Current facility sketch (LIC 999A) was reviewed, and Ana confirmed that the office (play area) inside the main house, the restroom on the adjacent building, and the outside play areas are accessible for children to use. All other rooms are off-limits and made inaccessible to the daycare children by the used of child's safety gate and children safety locks. There is a fireplace located in the off-limits living room and it is made inaccessible to the children using a fire screen protector. LPA observed a floor heater/air condition in the office (play area). Ana stated that when the heat is on, the floor heater does not get hot. Ana stated that there are no firearms in the home. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are inaccessible.

This is a single level home and there are no stairs. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. Fire drills are conducted and documented with the date, time and how many children present, every six months. Safe toys and play equipment were observed and are in good condition, free of sharp, loose, or pointed parts. There is an animal in the home. Ana understands the liability of pets around day care children and accepts responsibilities of any action taken by pets. The outdoor play area in the backyard is accessible to the children and is fenced and there are no hazards to children present. LPA observed a built-in swimming pool in the backyard which is fenced and made inaccessible. The pool gate is self-latching, self-closing and opens away from the swimming pool. No windows or doors have direct access to the pool area.

(Continued on LIC809-C).

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE: DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/20/2024
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 08/20/2024 03:35 PM - It Cannot Be Edited


Created By: Ka Vang On 08/20/2024 at 10:59 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: ESTRADA, ANA FAMILY CHILD CARE

FACILITY NUMBER: 503907875

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 08/20/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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During the indoor inspection, LPA observed a clear glass double French door with five grids on each side of the French door. One of the glass grids on the bottom of the door was missing. LPA observed Child #1 and Child #3 have access to the off-limits living room that stored the multiple gym equipment. In the backyard, LPA a portable propane tank still connected to a stove burner. This poses a potential health, safety, or personal rights risk to children in care.
POC Due Date: 09/04/2024
Plan of Correction
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During the inspection, Licensee immediately put the portable propane tank in an off-limits area. Licensee is to submit a plan indicate as to how she will ensure that children will not have access to the portable propane tank. Licensee also agrees to submit proof to the Department indicated that daycare children will not have access to the off-limits living room where multiple gyms equipment were stored.
Type B
Section Cited
CCR
102417(m)(3)
Operation of A Family Child Care Home
(3) A file of affidavits signed by each parent with a child enrolled in the home. The affidavit shall state that the parent has been informed that the family child care home does not carry liability insurance or a bond according to standards established by the state.

This requirement is not met as evidenced by:
Deficient Practice Statement
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During record review, there was no record indicated that the Affidavit Regarding Liability Insurance (LIC 282) was given to parent as there was record of LIC 282 in the children's file. This poses a potential health, safety, or personal rights risk to children in care.
POC Due Date: 09/04/2024
Plan of Correction
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Licensee agrees to submit proof to the Department by 09/04/2024 indicating that all daycare parents were provided notice Affidavit Regarding Liability Insurance (LIC 282).
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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Ka Vang
LICENSING EVALUATOR SIGNATURE:
DATE: 08/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/20/2024


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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ESTRADA, ANA FAMILY CHILD CARE
FACILITY NUMBER: 503907875
VISIT DATE: 08/20/2024
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Ana was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the Safe Sleep Regulations with Ana and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.



Ana has infant enrolled in the facility. Ana understands that there shall be one play yard for each infant in care, the play yard is kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the play yard. Infants are not swaddled while in care. Ana provided proof of physically checking on infants every fifteen minutes document any sign of distress, which includes but is not limited to flushed skin color, increase in body temperature, restlessness, and labored breathing on a sleeping log. Licensee understands that infants can be visually observed through an open door if sleeping in a separate room.

Ana 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. 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. Ana’s Mandated Reporter training was completed on 08/28/2023. Ana’s pediatric CPR/First Aid expires on 12/2024. A review of records indicates that Ana has immunization records on file for influenza, pertussis, and measles.

(Continued on LIC809-C).

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ESTRADA, ANA FAMILY CHILD CARE
FACILITY NUMBER: 503907875
VISIT DATE: 08/20/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

LPA and Ana 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.



Ana was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, the following deficiencies are being cited during today’s inspection. (See next page, LIC809-D).

Ana was provided a copy of appeal rights. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Ana.During the exit interview, Ana confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 08/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024
LIC809 (FAS) - (06/04)
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