Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 203806650
Report Date: 03/20/2018
Date Signed 03/20/2018 11:01:28 AM

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:URIBE, EVA FAMILY CHILD CAREFACILITY NUMBER:
203806650
ADMINISTRATOR:URIBE, EVAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(559) 664-0747
CITY:MADERASTATE: CAZIP CODE:
93638
CAPACITY:14CENSUS: 0DATE:
03/20/2018
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Licensee, Eva UribeTIME COMPLETED:
11:15 AM
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An Informal Office Meeting was conducted today at the Fresno Regional Child Care Office. In attendance at the meeting was Licensing Program Manager, Duane Matsubara, Licensing Program Analyst, Patricia Musso, Licensing Program Analyst, Kathie Campbell and Licensee, Eva Uribe. The purpose of this meeting Is to discuss recent violations of Title 22 Regulations that if not corrected, would pose a threat to child safety.

The following issues/violations were discussed:

Case Management on 12/1/2017
Type A deficiency 102417(g)(4) LPA Campbell observed Kaboom cleaner, razors and toiletries in the children's bathroom. LPA observed a child go to the bathroom by herself. This is an immediate risk to children in care.
Type A deficiency 102417(b) LPA observed the toilet seat was off of the toilet and the licensee was letting children sit on the rim of the toilet. LPA observed the toilet had urine on the rim and the inside of the toilet was not clean. Also there was no soap or towels to clean hands. This is unsanitary and is an immediate risk to child in care.
Case Management on 10/19/2017
Type A deficiency 102416.5(a)(b)(1)(2)(3) Upon LPA's arrival, licensee was caring for 9 children (3 infants and 6 children) by herself.
Complaint on 02/20/2018 Unsubstantiated - Licensee failed to provide adequate supervision.
Complaint on 01/12/2018 Unsubstantiated - Licensee does not live in the home and Licensee is absent from the home longer than the allotted amount of time.
Also, it was discussed with licensee the issue of her residing in her licensed facility. Licensee stated she is operating Monday-Friday from 2:45 AM to 6:00 PM.

It was discussed today that violations of Title 22 Regulations, and failure to maintain in compliance, may result in a Non-Compliance Conference being scheduled and the facility being referred to the Legal Division for possible Administrative Action. A copy of this signed report was given to Licensee, Eva Uribe on this date.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559)650-7855
LICENSING EVALUATOR NAME: Kathie CampbellTELEPHONE: (559) 341-4724
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2018
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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