543911845-7-14-2023-57-CC-ROCA-CTQR77-20230714124551

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 543911845
Report Date: 07/14/2023
Date Signed: 07/14/2023 12:46:03 PM

Document Has Been Signed on 07/14/2023 12:46 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:	PONCE DE CABRERA, ANGELA FAMILY CHILD CARE		FACILITY NUMBER:	543911845
ADMINISTRATOR:	PONCE DE CABRERA, ANGELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 564-9045
CITY:	WOODLAKE	STATE: CA	ZIP CODE:	93286
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 1	DATE:	07/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Angela Ponce de Cabrera		TIME COMPLETED:	01:00 PM

NARRATIVE

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On 7/14/2023, Licensing Program Analyst (LPA) Ruby Ocegueda, conducted an unannounced Annual Required Inspection and was met by Licensee, Angela Ponce de Cabrera. Licensee is Spanish Speaking and LPA Ocegueda assisted with interpretation. Days and hours of operation are Monday through Friday 5:00 AM to 7:15 PM or other hours as arranged.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that the kitchen, one bathroom, bedroom #1 and living room are used for providing care and are accessible to children. The back restroom and back bedroom were today although they are identified as off limits (See TV LIC 9102). Kitchen surfaces and a dresser in accessible bedroom had various items and clutter. All other rooms are off-limits and made inaccessible by use of door knob safety covers. Swimming pool is fenced per regulation. 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. There is a second gate near the shed that licensee indicated remains locked at all times and licensee indicated she will not remove the lock. The chain link fence has green slats that help make the fence unclimable. The self-latching gate also has slats but are spread apart further so that the pool area remains in view. There are no firearms or ammunition on the premises. All poisons are kept in a locked storage area. In the restroom were accessible lotions and toothpaste.

The fireplace located in the living is made inaccessible by a child furniture. 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) 723-7054.

LPA discussed Safe Sleep Regulations with licensee. Written resources were provided to licensee.

SUPERVISORS NAME: Susie Fanning
LICENSING EVALUATOR NAME: Ruby Ocegueda
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2023

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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Document Has Been Signed on 07/14/2023 12:46 PM - It Cannot Be Edited

Created By: Ruby Ocegueda On 07/14/2023 at 11:32 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: PONCE DE CABRERA, ANGELA FAMILY CHILD CARE	FACILITY NUMBER: 543911845
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(b)

Operation of A Family Child Care Home

(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview the licensee did not comply with the section cited above. Today, LPA observed discarded clothing, broken toys, and various debris in the side play yard. Licensee also had various items on the kitchen counters (non hazerdous) and on top of a dresser in bedroom #1. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/28/2023
	Plan of Correction
1 2 3 4	Licensee stated she would maintain yard free of discarded broken toys and various debris. Licensee stated she would send photos of her yard, kitchen counters and bedroom #1. Proof will be submitted to the Department by POC date 7/28/2023.

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: 07/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2023

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

FACILITY NAME: PONCE DE CABRERA, ANGELA FAMILY CHILD CARE	FACILITY NUMBER: 543911845
	VISIT DATE: 07/14/2023

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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 side was inspected and LPA observed various discarded items, some broken toys and debris. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files today (see LIC 9102). Licensee’s Mandated Reporter Training was completed on 7/2022. Licensee’s pediatric CPR/First Aid expires on 7/2025. 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: 07/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2023

LIC809 (FAS) - (06/04)

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