093615153-11-17-2022-03-CC-SMAX-CL9SLA-20221117125801

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 093615153
Report Date: 11/17/2022
Date Signed: 11/17/2022 12:58:27 PM

COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/17/2022 12:58 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	RAMIREZ, NORMA		FACILITY NUMBER:	093615153
ADMINISTRATOR:	RAMIREZ, NORMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 307-8383
CITY:	SOUTH LAKE TAHOE	STATE: CA	ZIP CODE:	96150
CAPACITY:	14	CENSUS: 1	DATE:	11/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Norma Ramirez		TIME COMPLETED:	01:00 PM

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On November 21^st, 2022 at approximately 10:00am Licensing Program Analyst (LPA) Soleil Marx and Licensing Program Manager (LPM) Natalie Dunaway, met with licensee Norma Ramirez for an unannounced annual / one year inspection. During the inspection there was a census of one child with Licensee. All individuals subject to criminal background review have obtained a criminal record clearance.

The home is a two-story home and the on-limits areas include the entire downstairs living area, the bathroom, kitchen, and the backyard. The Off-limits areas are: Entire upstairs, storage buildings in the backyard and front yard/driveway. The licensee stated that there are no firearms or bodies of water on the premises.

A health and safety inspection was conducted in the areas accessible to children. The house has a working telephone, fully charged fire extinguisher, smoke detector and carbon monoxide detector that meet regulations. LPA observed all the required postings. LPA advised the licensee that if there are any poisons at the home, all poisons must be locked with a key lock or combination lock. LPAs did not observed a fireplace within the facility.

Licensee has all of her immunization records current. Children's roster and a fire drill log were observed, the last fire drill was conducted on 07/02/2022. Licensee's CPR/First aid card had an expiration date of 07/09/2024. Mandated Reporter Training for licensee not required. LPAs observed complete children's files.

Report continues on 809C................

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Soleil Marx	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: RAMIREZ, NORMA	FACILITY NUMBER: 093615153
	VISIT DATE: 11/17/2022

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…… Continued from previous 809 page

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

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Licensee is aware of and practicing safe sleep regulations.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov. 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.

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. No deficiencies were cited during today’s inspection. Exit interview conducted and report was reviewed with the Licensee Norma Ramirez.

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Soleil Marx	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

LIC809 (FAS) - (06/04)

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