503912016-5-4-2023-04-CC-JYAZ-CRHTAF-20230504143329

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503912016
Report Date: 05/04/2023
Date Signed: 05/04/2023 02:33:40 PM

Document Has Been Signed on 05/04/2023 02:33 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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	ANDRADE, ROSA FAMILY CHILD CARE		FACILITY NUMBER:	503912016
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/04/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Rosa Andrade		TIME COMPLETED:	02:40 PM

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	On 05/04/2023, Licensing Program Analysts (LPAs), Jeovanna Yanez and Yesenia Fierro met with Applicant, Rosa Andrade for a pre-licensing inspection. Applicant, her husband, her adult daughter and two minor children 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 four bedroom, two bathroom home and children will have access to the front living room (daycare room), back living room, kitchen, dining room and hallway bathroom. Off-limits rooms are made inaccessible by use of plastic door knob covers. · There is a fireplace in the back living room that applicant states will not be used during day-care hours. · In the front living room, LPA observed learning wall art, two play yards, a rocking chair, a diaper changing table, children size furniture, wooden storage for cubbies, and safe games, toys, and books for the children. In the back living room, LPA observed a flat screen television mounted on the wall, comfortable furnishings, and two high chairs. Children will nap on cots, infants will nap on play yards in the front living room. 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. · Applicant’s Pediatric CPR and First Aid certification was completed through American Heart Association and expires on February 11, 2025. (CONTINUED ON 809-C)

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ANDRADE, ROSA FAMILY CHILD CARE	FACILITY NUMBER: 503912016
	VISIT DATE: 05/04/2023

NARRATIVE

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· Preventative Health and Safety Course with Prevention of Lead exposure certification was completed on February 22, 2023.
· Knives are stored in a bottom kitchen drawer made inaccessible via safety latch. Medications are stored in the off-limits master bathroom. Cleaning compounds are stored in a bottom kitchen cabinet made inaccessible via safety latch.
· 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 no pets in the home or on the premises.
· Applicant states there are no firearms or ammunition 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 has a cemented area, a sodded area, and an area with wood chips. LPA observed a patio porch for shade, and patio furniture. There is a wooden play structure, attached with a swing set. The ground level has a wooden ladder on one side of the structure that leads to the second level. The second level has a small observation deck with access to a blue plastic slide. LPA also observed two tricycles, a little tikes car, one small bike, a Grow N' Up bench, a kitchen play set, and a little tikes playhouse. (CONTINUED ON 809-C)

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ANDRADE, ROSA FAMILY CHILD CARE	FACILITY NUMBER: 503912016
	VISIT DATE: 05/04/2023

NARRATIVE

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· SB 792 immunizations verified and on file.
· Applicant completed the Mandated Reporter Training on March 27, 2023.
· LPA discussed safe sleep regulations and Safe Sleep Concepts were given to applicant.
· Incidental Medical Services (IMS) policy was discussed. Incidental Medical Services (IMS) are not currently being provided. 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.

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. Applicant is also reminded that it is her responsibility to read the regulations periodically. Applicant states she will operate her day care Monday through Friday, 24 hours. Overnight care will be provided. "Overnight Care" means care being provided to children anytime between the hours of 6:00 PM and 6:00 AM. Care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered into care.

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.

Pending a final review of application file, licensure as a Small Family Day Care Home capacity of 8 children ages under 18 years will be recommended effective 05/05/2023.

SUPERVISORS NAME: Rene Mancinas
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

LIC809 (FAS) - (06/04)

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