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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 103905949
Report Date: 12/05/2022
Date Signed: 12/05/2022 05:06:25 PM

Document Has Been Signed on 12/05/2022 05:06 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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:ROCHA, MARIA FAMILY CHILD CAREFACILITY NUMBER:
103905949
ADMINISTRATOR:ROCHA, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 252-5711
CITY:FRESNOSTATE: CAZIP CODE:
93727
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
12/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Maria RochaTIME COMPLETED:
05:15 PM
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On 12/05/2022, Licensing Program Analyst (LPA) Ka Vang conduct an unannounced Annual Required Inspection and was met by Licensee Maria Rocha. Days and hours of operation are Monday through Friday, from 7:00 AM-5:00 PM. The home has a working telephone service and LPA confirmed the phone number is 559-259-0244.

LPA toured the home inside and outside. Census was taken and there 4 day care children present. Current facility sketch (LIC 999A) was reviewed, and Licensee confirmed that the playroom, kitchen, greatroom, bedroom and hallway bathroom are used for providing care and accessible to day care children. All other rooms are off-limits and made inaccessible by use of plastic doorknob cover. There is a fireplace in the home located in the living room but made inaccessible to the children by fire screen. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are inaccessible.

This is one story home. 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 are two dogs. Licensee 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. During outdoor inspection, LPA observed the pop-up Gazebo in the backyard was not secured on the ground. The gazebo is wobbling and may fall on the children in care. Licensee agreed to will remove the gazebo immediately. A technical assistance was given on today’s visit. (See attached LIC9102).

Licensee has two infants enrolled in the facility. There are two cribs for each infant in care. LPA observed two large toys and a small pillow in the crib.

(Continued on LIC809-C).

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2022
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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Document Has Been Signed on 12/05/2022 05:06 PM - It Cannot Be Edited


Created By: Ka Vang On 12/05/2022 at 04:11 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: 103905949

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/05/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(1)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall physically check on the infant every 15 minutes.

This requirement is not met as evidenced by:
Deficient Practice Statement
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During record review, Licensing Program Analyst (LPA) Ka observed that Licensee did not conducted the physically check on the Child #1 (CH1) and Child #3 (CH3) as Licensee did not have record indicated Licensee physically check CH1 and CH3.
POC Due Date: 12/19/2022
Plan of Correction
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Per Licensee, she will start logging the 15 minutes log for Child #1 (CH1) and Child #3 (CH3) and will submit proof of the log to LPA by 12/19/2022.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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 During record review, LPA observed Licensee did not have her current training of the mandated reporter training (AB1207). Licensee's mandated reporter training was completed 09/13/2018.
POC Due Date: 12/19/2022
Plan of Correction
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Per Licensee, she will complete the mandated reporter training (AB1207) and submit proof of completion to LPA by 12/19/2022.
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:Michael Duarte
LICENSING EVALUATOR NAME:Ka Vang
LICENSING EVALUATOR SIGNATURE:
DATE: 12/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/05/2022


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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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ROCHA, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 103905949
VISIT DATE: 12/05/2022
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Licensee stated that Child #4 (C4) have just put the toys and pillow inside the crib. Licensee immediately put the toys and small pillow away and the cribs are free of loose article or object. There are no objects hanging above or attached to the cribs. Infants are not swaddled while in care. Child #1 (CH1) Child #3 (CH3) did not have the every fifteen minutes log record. A deficiency of Type B was issued during today’s visit due to there was no records of the log. (See attached LIC809-D). LPA advised licensee that she is required to 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. Infants can be visually observed through an open door if sleeping in a separate room.

LPA discussed the safe sleep regulations with licensee 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 resources. 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.



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. 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 09/13/2018. A deficiency of Type B was issued during today’s visit due to there was no current Mandated Reporter training in file. (See attached LIC809-D). Licensee’s pediatric CPR/First Aid expires on 10/2023. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis, and measles.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

(Continued on LIC809-C).

SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2022
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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: ROCHA, MARIA FAMILY CHILD CARE
FACILITY NUMBER: 103905949
VISIT DATE: 12/05/2022
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Incidental Medical Services (IMS) policy was discussed, and facility is not providing IMS. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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/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.



To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to [email protected]. 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/process.


Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, the following deficiencies are being cited: (see next page, 809 D).

Licensee 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 Licensee Maria Rocha.
SUPERVISORS NAME: Michael Duarte
LICENSING EVALUATOR NAME: Ka Vang
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2022
LIC809 (FAS) - (06/04)
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