243909084-9-6-2019-04-CC-GBAA-BFRN25-20190906100409

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 243909084
Report Date: 08/27/2019
Date Signed: 09/06/2019 10:04:13 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:	JARAMILLO, JACQUELINE FAMILY CHILD CARE		FACILITY NUMBER:	243909084
ADMINISTRATOR:	JARAMILLO, JACQUELINE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 725-9452
CITY:	MERCED	STATE: CA	ZIP CODE:	95341
CAPACITY:	14	CENSUS: 0	DATE:	08/27/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Dina Gonzalez		TIME COMPLETED:	11:30 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	Licensing Program Analysts (LPAs) Ginny Badhesha and Rene Mancinas conducted an unannounced annual inspection and met with Licensee’s Mother (who is fingerprint cleared), Dina Gonzalez. LPAs explained the reason of the inspection and a tour of the home was conducted both inside and outside as shown on the facility sketches (LIC 999A). Present in the home was the Licensee’s Mother, no day care children were in the home. There is no fireplace in the home. There are no stairs in the home. LPAs observed plenty of age appropriate toys in home and observed that the house was clean and free of toxins. The knives and medications are stored up high in a cabinet in the kitchen. The chemicals and cleaning supplies are stored in the garage, which is inaccessible. The backyard has a fence that goes all around, there was plenty of shade. A dog was observed during today’s inspection; licensee understands responsibility of any action taken by pets involving day care children. The last time Licensee conducted the fire/emergency drills with children was on August 19, 2019. Children's files were reviewed along with the children's roster and everything was completed and up to date. Licensee is current with the immunization requirements per SB 792. Licensee has taken the Mandated Reporter Training AB 1207 on October 17, 2018. Licensees CPR/First Aid certificate expires on January 16, 2021. LPAs spoke about the safe sleep regulations with Licensee and reminded her to not store anything inside the cribs and playpens. LPAs also provided licensee with a safe sleep brochure and the new lead brochure. Licensee has a 2A10 BC fire extinguisher. The carbon monoxide and smoke detector were tested and found in working condition. There was adequate heating and ventilation for safety and comfort. Licensee stated that she does not have any guns or ammunition in the home and LPAs did not observe any bodies of water during the inspection. There is a working telephone and number was verified. (Continued on 809-C)

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Gagandip Badhesha	TELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: JARAMILLO, JACQUELINE FAMILY CHILD CARE	FACILITY NUMBER: 243909084
	VISIT DATE: 08/27/2019

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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

Days and hours of operation are Monday through Friday; 5:00am-6:00pm.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited today.

Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

FAILURE TO POST THE LIC 9213 NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Gagandip Badhesha	TELEPHONE: (559) 575-6900
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019

LIC809 (FAS) - (06/04)

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