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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293607272
Report Date: 12/15/2022
Date Signed: 12/15/2022 03:07:32 PM


Document Has Been Signed on 12/15/2022 03:07 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:GONZALEZ, MARIAFACILITY NUMBER:
293607272
ADMINISTRATOR:GONZALEZ, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 587-5597
CITY:TRUCKEESTATE: CAZIP CODE:
96161
CAPACITY:14CENSUS: 7DATE:
12/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Maria GonzalezTIME COMPLETED:
04:00 PM
NARRATIVE
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On Thursday, December 15th, 2022, at 12:25pm, Licensing Program Analysts (LPAs) Matthew Gallo and Lea Habtom met with the Licensee, Maria Gonzalez, for the purpose of an unannounced Annual Required inspection. The Licensee's assistant arrived at approximately 12:40pm. At 12:30pm, 4 infants and 3 preschool age children were observed alone with licensee. Licensee’s adult children were present in the home at the time of inspection however were visiting.

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.

Operating hours are 7:30am to 4:30pm, Monday through Friday.



LPAs conducted a health and safety inspection of all areas accessible to children. Off-limits areas include the Master Bedroom, Outside Sheds, and Garage. Licensee acknowledged that children may never enter these off-limit areas.

LPA observed a working phone, fire extinguisher, and functioning smoke detector and carbon monoxide detectors. Licensee stated there are no weapons in the home. Toxic and hazardous items (detergents, cleaning compounds, medications, sharp utensils, items that could pose a danger to children in care) are properly stored.

Licensee has a fireplace waiver that allows it to be barricaded with potted plants to prevent access by children. Continued on 809-C
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Matthew GalloTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2022
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: GONZALEZ, MARIA
FACILITY NUMBER: 293607272
VISIT DATE: 12/15/2022
NARRATIVE
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There are stairs in the home which are not properly barricaded, as any barrier or gate is missing.

Safe toys and play equipment are observed.



The outdoor play space is fenced. The Licensee understands that in unfenced outdoor areas, 100% supervision of children is required.

There are no bodies of water on the premises.

LPAs reviewed Children’s files and other documentation. A current roster is being maintained. Licensee's fire and disaster drills are conducted. Mandated reporter training was waived due to language barrier.

Upon arrival, LPAs observed violations of safe sleep regulations. Five children were napping in play yards that all contained blankets inside, as well as blankets draping the sides and top to block out light. In addition, one infant was in a car seat placed inside a play yard. LPAs reviewed the safe sleep regulations with licensee and reminded licensee of 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 licensee 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.

LPAs reviewed children’s, personnel, and administrative records.

This facility does not provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Continued on 809-C

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Matthew GalloTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
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: GONZALEZ, MARIA
FACILITY NUMBER: 293607272
VISIT DATE: 12/15/2022
NARRATIVE
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Licensee was encouraged to visit the Department website at http://ccld.ca.gov for child care updates, current forms, legislation and regulation information.

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/process.

Title 22 Deficiency has been cited on the attached LIC 809-D. LPA Gallo informed Maria Gonzalez that this report dated December 15, 2022 documents 2 Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care. Also, LPA Gallo informed Maria Gonzalez to provide a copy of this licensing report dated December 15, 2022 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Appeal Rights given.

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.

Exit interview conducted and report was reviewed with the licensee, Maria Gonzalez.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Matthew GalloTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/15/2022 03:07 PM - It Cannot Be Edited

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: GONZALEZ, MARIA
FACILITY NUMBER: 293607272

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(h)
Infant Safe Sleep
Car seats shall only be used for transportation purposes and shall not be used for sleeping.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that LPAs observed licensee removing a napping infant from the carseat in a playyard which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/19/2022
Plan of Correction
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Licensee agreed to not use the carseat as a sleeping environment for infants and to place the infant in the playyard on the back. LPAs had licensee remove the carseat at the time of inspection.
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that LPAs observed 4 infants and 3 preschool children being cared for by licensee at the time of arrival. During the inspection, a parent picked up an infant and the assistant came. This poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/19/2022
Plan of Correction
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LPAs reviewed ratio guidelines with licensee for a large family child care home which licensee agreed to adhere to. Licensee stated one child dropped in on a day that was not scheduled but will address with parents and assistant regarding her schedule.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Matthew GalloTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2022
LIC809 (FAS) - (06/04)
Page: 3 of 5


Document Has Been Signed on 12/15/2022 03:07 PM - It Cannot Be Edited

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: GONZALEZ, MARIA
FACILITY NUMBER: 293607272

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(3)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that there was no baby gate on the stairs. Licensee was using two playyards that are moveable as a barrier however LPAs notified licensee that children can push the playyards gaining access to stairs which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/29/2022
Plan of Correction
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Licensee agreed to keep gate stairs on stairs at all times. Licensee placed the gate on the stairs as LPAs were present in the home.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Matthew GalloTELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:
DATE: 12/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/15/2022
LIC809 (FAS) - (06/04)
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