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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153911236
Report Date: 11/10/2021
Date Signed: 11/10/2021 01:51:03 PM

Document Has Been Signed on 11/10/2021 01:51 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:MONTEJANO, ALICIA FAMILY CHILD CAREFACILITY NUMBER:
153911236
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/10/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Alicia MontejanoTIME COMPLETED:
02:00 PM
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On November 10, 2021, Licensing Program Analyst (LPA), Norma Lomeli conducted a capacity increase inspection from a Small Family Child Care Home to a Large Family Child Care Home. Present at time of inspection was licensee, her adult grandson and two minor children. Verified licensee CPR and First Aid was completed through Pediatric Plus with Emergency Medical Services Authority stickers (EMSA) and expires on June 27, 2023. Licensee’s Assistant, Angel Mejia has not completed the training. Licensee understands that the assistant will not be left alone to care and supervise the day care children. Background criminal record clearances are verified and discussed, and LIS 531 is signed. Fire clearance was granted on October 15, 2021.

A tour of the home, inside and outside, as shown on the facility sketch, was conducted and the following was discussed and/or observed:
  • Fire clearance was received on October 25, 2021. Fire alarm is located in the home’s entry way on the left hand side wall.
  • LPA observed safe toys and a play yard in the living room. There is a parent’s board that is located on the living room.
  • Licensee states she does not have weapons, firearms, ammunition or poisons in the home.
  • Facility has 3A40BC fire extinguisher, carbon monoxide alarm, working smoke alarm and first aid kit in place.
  • Licensee 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). Licensee states the home is smoke-free.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2021
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
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MONTEJANO, ALICIA FAMILY CHILD CARE
FACILITY NUMBER: 153911236
VISIT DATE: 11/10/2021
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Pending verification of corrections of the items on LIC809-C and a final review of her application, licensure as a Large Family Day Care Home capacity of 14 children ages under 18 years will be recommended

During exit interview, LPA observed licensee post the Notice of Site Visit on parent’s board and understands it must remain posted for 30 days and retain evaluation report for 3 years.
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
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: MONTEJANO, ALICIA FAMILY CHILD CARE
FACILITY NUMBER: 153911236
VISIT DATE: 11/10/2021
NARRATIVE
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  • Licensee states she will be transporting day care children. Licensee understands that she must have proper vehicle restraints and/or car seats for all the children under her care when transporting children.
  • Required items are posted in the Child Care Home where parents my easily view.
  • During visit capacity worksheet was provided and discussed.
  • Licensee and assistant have not completed the Mandated Reporter Training.
  • LPA discussed safe sleep pending regulations and Safe Sleep Regulation Concepts were given licensee.


LPA & licensee discussed the Community Care Licensing website: LPA and licensee 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.

Licensee states her hours of operation are Monday through Sunday, 24 hours and as arranged. Licensee is advised that she does not provide care for more than 24 hours. Licensee is advised she may access forms and updated information on the CCLD website at www.ccld.ca.gov.

Licensee is advised the following items must be corrected and documentation be sent to Fresno CCL within the next 60 days to avoid possible withdraw.
  • Licensee and licensee’s assistant will complete the Mandated Reporter Training. License will provide proof of certification to LPA. Training can be found at www.ccld.ca.gov or at www.mandatedreporteca.com.
  • Facility is pending fingerprint clearances for two adults.
(Continued on LIC809-C):
SUPERVISORS NAME: Duane Matsubara
LICENSING EVALUATOR NAME: Norma Lomeli
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2021
LIC809 (FAS) - (06/04)
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