115408030-1-31-2022-13-CC-EGRK-CB7PY5-20220131104323

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 115408030
Report Date: 01/31/2022
Date Signed: 01/31/2022 10:43:33 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	SARMENTO FAMILY CHILD CARE HOME		FACILITY NUMBER:	115408030
ADMINISTRATOR:	SARMENTO, CASSANDRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 514-6136
CITY:	ORLAND	STATE: CA	ZIP CODE:	95963
CAPACITY:	14	CENSUS: 0	DATE:	01/31/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Cassandra Sarmento		TIME COMPLETED:	10:55 AM

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	A prelicensing inspection visit was conducted today by LPA, Emilia Grisak. The applicant is requesting a license for a capacity of 14. Fire clearance was approved on 1/10/22 for 14 children. Services will be provided Monday -Friday; 6:30am – 5:30pm. The applicant understands that child care must be provided in the "primary" residence of the applicant. The residence is a three bedroom/two bath home. There are two adults living in the home. Applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. All minors residing in the home must be fingerprinted within 30 days of reaching their 18th birthday and obtain a TB clearance. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance. The garage and master bedroom and master bath are off limits to the children. These areas have been made inaccessible by means of door locks and door knob covers. The home appears to be clean and orderly at this time and will remain so during child care hours. There is a working telephone. The sharp knives, cleaning supplies, medicines are stored out of the reach of children. There were no poisons observed in the home and applicant was advised that poisons must be locked when present. The applicant reports there is a BB gun in the home and it is locked and ammunition is not stored on site. Applicant was advised that weapons must be locked and ammunition locked and stored separately if present. The children in care will have access to age appropriate toys and equipment. The home is equipped with a working smoke detector and carbon monoxide detector. The children will use the backyard as the outdoor play area. The backyard is completely fenced. There is a trampoline on the premises in an off limits area of the backyard. There is no pool, spa, pond, fountain, nor any other source of water accessible to the children, and none is to be added without prior notification and approval of the licensing agency.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Emilia Grisak	TELEPHONE: (530) 895-5821
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

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
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: SARMENTO FAMILY CHILD CARE HOME	FACILITY NUMBER: 115408030
	VISIT DATE: 01/31/2022

NARRATIVE

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Parents will be required to sign insurance affidavits if the provider does not plan to purchase additional child care liability insurance. Landlord consent is on file. Parent's rights will be posted in daycare room. Emergency drills must be conducted at least once every six months and the date documented. Children's records to be maintained were reviewed. The roster is to remain current at all times. Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report within seven days. The applicant will maintain current on Pediatric CPR and First Aid and current CPR/FA expires on 10/15/23. The applicant shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current Pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged. Smoking is prohibited during the hours of operation in those areas where children are present.

The applicant understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website. http://ccld.ca.gov/
Megan's Law web site was provided (http://www.meganslaw.ca.gov). The licensee understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice. LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

The following must be completed prior to licensure.

1. Proof of fire extinguisher rated at least 2A10BC

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Emilia Grisak	TELEPHONE: (530) 895-5821
LICENSING EVALUATOR SIGNATURE:	DATE: 01/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2022

LIC809 (FAS) - (06/04)

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