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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243806059
Report Date: 07/25/2022
Date Signed: 07/29/2022 09:55:17 AM

Document Has Been Signed on 07/29/2022 09:55 AM - 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:DANA'S DAY CAREFACILITY NUMBER:
243806059
ADMINISTRATOR:HAUMEA, DANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 769-1293
CITY:LOS BANOSSTATE: CAZIP CODE:
93635
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
07/25/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Dana HaumeaTIME COMPLETED:
01:45 PM
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On 07/25/2022 Licensing Program Analysts (LPAs) Robert Gutierrez and Priscilla Zamudio, conducted an unannounced complaint inspection and was met by Licensee, Dana Haumea.

LPAs toured the home inside and outside and a census was taken. While touring the home LPAs observed Infant #1 sleeping in bedroom with the door closed. LPAs entered the bedroom and observed Infant #1 sleeping in a play yard with a blanket. After discussion, Licensee removed the blanket and stated the bedroom door shall remain open when an infant is sleeping in the bedroom.

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: Robert Gutierrez
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2022
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 07/29/2022 09:55 AM - It Cannot Be Edited


Created By: Robert Gutierrez On 07/25/2022 at 12:56 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: DANA'S DAY CARE
FACILITY NUMBER: 243806059

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/25/2022
Section Cited
CCR
102425(b)

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Infant Safe Sleep. Cribs or play yards shall be free from all loose articles and objects. During inspection, LPA observed Infant #1 sleeping in a bedroom with the door closed and a blanket inside the play yard.
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Licensee removed the blanket and stated the door shall remain open when an infant is sleeping in the bedroom. LPAs then discussed safe sleep laws with licensee.
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This poses as a potential risk to the health safety or personal rights of children in care.
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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:Robert Gutierrez
LICENSING EVALUATOR SIGNATURE:
DATE: 07/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2022


LIC809 (FAS) - (06/04)
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