503911696-3-18-2024-04-CC-YFIO-D3H5ND-20240318200610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503911696
Report Date: 03/07/2024
Date Signed: 03/18/2024 08:06:18 PM

Document Has Been Signed on 03/18/2024 08:06 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:	CHAVEZ, LLOBANA FAMILY CHILD CARE		FACILITY NUMBER:	503911696
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 4	DATE:	03/07/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:32 AM
MET WITH:	Llobana Chavez		TIME COMPLETED:	10:30 AM

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On 03/07/2024 Licensing Program Analysts (LPAs), Yesenia Fierro and Erica Pacheco conducted an unannounced annual required inspection. LPAs were met by Licensee, Llobana Chavez. LPAs explained the reason for the visit. LPAs confirmed days and hours of operation are Monday through Friday from 6:00 a.m. – 5:00 p.m. The home has a working telephone service and LPAs confirmed the phone number is (209) 458-9567. 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.

LPAs conducted a census, during today’s inspection there were 4 children in care, capacity as specified on the license is being maintained. A current facility sketch was reviewed, and Licensee confirmed that the living room, playroom, dining room, bathroom and front yard and are accessible to children. All other rooms are off-limits and made inaccessible by use of safety latches, safety gates, lock clips, and cabinet latches.

LPAs toured the home inside and outside; this is a single-story home. LPAs observed age-appropriate toys, dramatic play equipment, books, educational materials for the children in care. The homes floors, carpets, surfaces were observed to be clean and serviceable order.

The fireplace located in the playroom is made inaccessible by a glass door. Licensee stated that fireplace will not be in use during daycare hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. LPAs observed licensee test the smoke detector and carbon monoxide. Licensee understands to test both smoke detector and carbon monoxide periodically for functionality. There are no firearms or ammunition on the premises.

Licensee stated that all poisons are kept in the storage room in the backyard. LPAs did not observe any poisons during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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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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: CHAVEZ, LLOBANA FAMILY CHILD CARE	FACILITY NUMBER: 503911696
	VISIT DATE: 03/07/2024

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Per licensee backyard is not accessible to children. LPAs observed an inground pool/spa, both pool and spa were empty. Swimming pool is fenced per regulation. The pool gate is self-latching, self-closing and opens away from the swimming pool. LPAs observed the backyard is fenced and there are no hazards to children present. LPAs observed the front yard has age-appropriate dramatic play toys and bikes/cars. LPAs observed a storage shed in the front yard where toys are stored. LPAs observed the front yard is fenced and there are no hazards to children present.

Licensee has a current roster of the children. An emergency fire/disaster drill was completed on February 15, 2024. Licensee’s Mandated Reporter Training was completed on 05/03/2023. Licensee’s pediatric CPR/First Aid expires on 03/18/2023. A review of records indicates that all employees and children records were complete. 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.

Licensee stated she is caring for one (1) infant. LPA observed one crib or play yard for each infant in care, 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. License stated that infants are not swaddled while in care. Licensee 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. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

LPA discussed the safe sleep regulations with licensee Llobana Chavez and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee Llobana Chavez 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.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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: CHAVEZ, LLOBANA FAMILY CHILD CARE	FACILITY NUMBER: 503911696
	VISIT DATE: 03/07/2024

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

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

During the exit interview, the licensee Llobana Chavez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Licensee Llobana Chavez was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

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, no deficiencies are cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Llobana Chavez.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

LIC809 (FAS) - (06/04)

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