010212181-1-27-2020-02-CC-CCON-BL8VFB-20200127152340

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 010212181
Report Date: 01/08/2020
Date Signed: 01/27/2020 03:23:47 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	JARAMILLO, ROSA		FACILITY NUMBER:	010212181
ADMINISTRATOR:	JARAMILLO, ROSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 527-3951
CITY:	ALBANY	STATE: CA	ZIP CODE:	94706
CAPACITY:	12	CENSUS: 10	DATE:	01/08/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Rosa Jaramillo		TIME COMPLETED:	05:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst Caroline Colson met with Rosa Jaramillo and her adult daughter, Jessica Jaramillo for an unannounced random annual inspection at 3:00 PM. There are 10 preschool children present. One child's record was reviewed by the LPA and the licensee on 1/08/20 at 4:06 PM. C1 has immunization records available in the file. Licensee stated to the analyst that there are no additional records available in the facility. The home was toured to conduct a health and safety inspection. The home is a one story home. The home consists of a living room, dinning room, kitchen, upstairs two bedrooms, one upstairs bathroom, downstairs basement which has been converted into a bathroom and two play rooms, unfenced front yard, fenced back yard, garage, carport, outside art studio and garden. The off limit areas are the unfenced front yard, garage, two upstairs bedrooms and carport. Ms. Jaramillo will use her fenced back yard for outdoor play. The home has a 2A10BC fire extinguisher, a working smoke detector and working carbon monoxide detector. There is central heating. Mrs. Jaramillo states there are no firearms in the home. The living room is the isolation room. She conducts fire/disaster drills every month. Her infant CPR and First Aid certificates are current and expire on April 8, 2020. She has a first aid kit. Mrs. Jaramillo has five chickens, three dogs, five fishes and one bird. This facility is providing Incidental Medical Services. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family child care home evaluator manual (FCCH EM) Policy 102417. Please LIC 809 C for additional information

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: JARAMILLO, ROSA	FACILITY NUMBER: 010212181
	VISIT DATE: 01/08/2020

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

REMINDERS/RESOURCES

· Criminal Background Clearance: All assistants, volunteers, frequent adult visitors (adults are individuals 18 years of age or older) must be fingerprint cleared and associated to the facility prior to be in the presence of children in care. Failure to comply, requires an immediate civil penalty of $100 to $3000 per person, per incident.

· CCLD Complaint Hotline, 1-844-LET-US-NO (1-844-538-8766) email: LetUsNo@dss.ca.gov

· NEW LAW: Safe Sleep Regulations: http://www.cdss.ca.gov/inforesources/Child-Care-Licensing/Public-Information-and-Resources/Safe-Sleep

· Licensees and all staff are Mandated Reporters and are required to report to CCLD any suspected child abuse.

CCLD website address for obtaining licensing forms, training videos and other provider resources can be obtained at www.ccld.ca.gov

· Licensees may register to receive child care updates: www.myccl.ca.gov

The mandated reporter training was discussed and needs to be completed every two years.
Licensee was reminded to ensure all electrical outlets are covered or inaccessible to children to prevent injury.

All immunization records and mandated reporter training certificates will be sent to our department within 30 days.

There were no deficiencies cited during this inspection.

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline Colson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2