543903627-6-10-2022-57-CC-ROCA-CF9SA4-20220610134143

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543903627
Report Date: 06/10/2022
Date Signed: 06/10/2022 01:41:56 PM

Document Has Been Signed on 06/10/2022 01:41 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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	ROCHA, MARIA FAMILY CHILD CARE		FACILITY NUMBER:	543903627
ADMINISTRATOR:	ROCHA, MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 564-8946
CITY:	WOODLAKE	STATE: CA	ZIP CODE:	93286
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	06/10/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Maria Rocha		TIME COMPLETED:	02:00 PM

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On 6/10/2022, Licensing Program Analyst (LPA), Ruby Ocegueda conducted an unannounced Annual Required Inspection and was met by Licensee, Maria Rocha. Also present was Staff #2 (S2). Licensee is Spanish Speaking and LPA Ocegueda assisted with interpretation. Days and hours of operation are Monday through Friday from 6:00 AM to 5:30 PM.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that day care room and one attached bathroom are used for providing. All other rooms are off-limits and made inaccessible by use of plastic door knob safety cover. There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. In the side of the yard, there was a container of Ortho Insect Killer. The Insect Killer container had a child proof nozzle. The door to the back yard was locked today. Today, Licensee removed it and placed inside the locked storage shed where she stated is usually stored. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There are no fireplaces or open face heaters in the home. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559) 564-8946.

LPA discussed Safe Sleep Regulations with licensee. There is 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. Infants are not swaddled while in care. Provider 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.

Report continued on page 809-C

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2022

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 SOUTH CC, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: ROCHA, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 543903627
	VISIT DATE: 06/10/2022

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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. The outdoor play area in the backyard is fenced and there are no hazards to children present. 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. Licensee’s Mandated Reporter Training was completed on 5/6/2022. Licensee’s pediatric CPR/First Aid expires on 4/22/2024. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

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.

Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA and Licensee 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.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiency is being cited: (see next page, 809 D) Licensee was provided a copy of appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:	DATE: 06/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/10/2022 01:41 PM - It Cannot Be Edited

Created By: Ruby Ocegueda On 06/10/2022 at 01:03 PM

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: ROCHA, MARIA FAMILY CHILD CARE	FACILITY NUMBER: 543903627
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/10/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(4)

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: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above. During the inspection of the play yard, Licensing Program Analyst (LPA) Ocegueda observed a container of Ortho insect killer. The container had a child proof nozzle and it was sealed. LPA reviewed the regulation with licensee, and she confirmed that her husband/assistant had forgotten to place the bottle back inside the locked shed. Today, the door to the back yard was locked, however licensee stated she occasionally used the play yard. The container was placed back in the locked shed. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/17/2022
	Plan of Correction
1 2 3 4	Today, Licensee placed the Ortho Insect Killer back in the locked shed. Licensee completed a written statement indicating understanding that poisons and other potentially hazardous items should be locked and/or inaccessible to children in care at all times.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Susie Fanning

LICENSING EVALUATOR NAME:

Ruby Ocegueda

LICENSING EVALUATOR SIGNATURE:

DATE: 06/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/10/2022

LIC809 (FAS) - (06/04)

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