Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503602859
Report Date: 08/04/2017
Date Signed 08/04/2017 02:35:02 PM

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:HARLEN, BRENDAFACILITY NUMBER:
503602859
ADMINISTRATOR:HARLEN, BRENDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 545-9161
CITY:SALIDASTATE: CAZIP CODE:
95368
CAPACITY:14CENSUS: 6DATE:
08/04/2017
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Brenda HarlenTIME COMPLETED:
03:00 PM
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An annual random visit #3 is being conducted by LPA Claudia Henley. I was met by licensee Ms. Harlen and two adult fingerprinted assistants. There were six children present. A tour of the home, inside and outside, as shown on the facility sketch is provided. There are no firearms in this home. There is a spa in the backyard that is fenced. The vinyl top cover on the spa is locked on all four sides and is within regulation. Licensee stated that at this time the spa is currently empty of water. There is a very small bird pond in the front yard which had no water inside. Poisons, cleaning compounds, medications and other hazardous items are inaccessible to children. Fireplace is not used during day care. There is a working fire extinguisher, a smoke detector, carbon monoxide detector and there is adequate heating and ventilation for safety and comfort. The fire/disaster drill was conducted on July 2017. There are no stairs in the home. Safe toys and play equipment are observed. There is a working telephone. Adequate supervision is being provided during this visit. Children are supervised when outside in the fenced play area. There are two dogs on the premises and have access to the children. There are chickens in the back yard and inaccessible to the children by a fence. Licensee is aware of the liability when it comes to the health and safety of the children around pets. Capacity as specified on the license is being maintained. Staff-child ratios are maintained. 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. Medication is being given. Pediatric First/Aid & CPR is current on licensee. Reviewed six children's files today. Staff and licensee are current on immunization. The day care hours and days of operation are: Monday through Friday, 7:30 a.m. to 5:30 p.m.
No deficiencies were cited during today's visit. Site Visit Notice posted on the parent board. Exit interview was conducted.
Incidental Medical Services (IMS) policy was discussed . 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: http://www.ada.gov/childqanda.htm
SUPERVISOR'S NAME: Valarie ReedTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 08/04/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/04/2017
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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