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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 243911930
Report Date: 04/04/2024
Date Signed: 04/16/2024 09:39:03 AM

Document Has Been Signed on 04/16/2024 09:39 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:MUNOZ JAIME, SANDRA FAMILY CHILD CAREFACILITY NUMBER:
243911930
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 4DATE:
04/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Sandra Munoz JaimeTIME COMPLETED:
01:15 PM
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On 04/04/2024 Licensing Program Analyst (LPA), Yesenia Fierro conducted an unannounced Annual Required Inspection and was met by Licensee, Sandra Jamie Munoz. LPA explained the reason for the visit. LPA Fierro confirmed days and hours of operation are Monday through Friday from 7:00 a.m. through 7:00 p.m. The home has a working telephone service and LPA Fierro confirmed the phone number is (209) 534-0953. 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.

LPA Fierro conducted a census, capacity as specified on the license is being maintained. A current facility sketch was reviewed, and Licensee confirmed that the kitchen, dining room, hallway bathroom, living room, playroom and back yard are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of door spinners, safety gates, and bolted lock. Licensee stated there are no firearms, ammunition, pets in the home.

LPA Fierro toured the home inside and outside. This is a two-story home. LPA observed stairs upon entering the front door, stairs are fenced when children under age 5 years old are present. LPA did not observe any 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. LPA observed licensee test the smoke detector and carbon monoxide. Licensee understands to test both smoke detector and carbon monoxide periodically for functionality. Licensee stated that all poisons are kept in a storage shed in the backyard. LPA did not observe any poisons during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

During today’s inspection there were 4 children in care, upon today’s arrival licensee opened the garage door for LPA to enter the home. Upon entering the garage LPA observed licensee was utilizing the garage to provide care. LPA asked licensee if she had conducted any changes to her sketch , licensee stated no. licensee stated she was under the impression that she was able to use the entire lower level of her home. LPA explained she is to only use the areas that were accessible to children. Licensee stated she understood.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE: DATE: 03/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2024
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 04/16/2024 09:39 AM - It Cannot Be Edited


Created By: Yesenia Fierro On 04/04/2024 at 12:19 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: MUNOZ JAIME, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 243911930

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation the licensee did not comply with the section cited above. Licnesee was providing care in the garage which is an inaccessible area which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/11/2024
Plan of Correction
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LIcensee will move any daycare items out of the garage
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Juvenal Moctezuma
LICENSING EVALUATOR NAME:Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:
DATE: 04/04/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/04/2024


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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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MUNOZ JAIME, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 243911930
VISIT DATE: 04/04/2024
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LPA observed the home to be safe and clean. LPA observed plenty inside toys, books, and dramatic play accessories. The outdoor play area in the backyard is fenced and there are no hazards to children present. LPA did not observe a swimming pool or other bodies of water on the premises, and Licensee stated that here are no swimming pool or other bodies of water. LPA observed outdoor toys and an age-appropriate wooden play structure.

Licensee has a current roster of the children. An emergency fire/disaster drill was been completed January 10, 2024. Licensee’s Mandated Reporter Training was completed on 07/24/2022. Licensee’s pediatric CPR/First Aid expires on 08/31/2024. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis, and measles. 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.

Licensee stated she is caring for infants. LPA observed 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. License stated that infants are not swaddled while in care. Licensee 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.

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-andresources/safe-sleep as an additional resource. 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.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
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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 CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: MUNOZ JAIME, SANDRA FAMILY CHILD CARE
FACILITY NUMBER: 243911930
VISIT DATE: 04/04/2024
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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/resources/child-care-centers/. Licensee was informed of the

MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee Sandra Jamie Munoz, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.



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.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Sandra Jaime Munoz.

SUPERVISORS NAME: Juvenal Moctezuma
LICENSING EVALUATOR NAME: Yesenia Fierro
LICENSING EVALUATOR SIGNATURE:

DATE: 04/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/04/2024
LIC809 (FAS) - (06/04)
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