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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617821
Report Date: 06/13/2023
Date Signed: 06/13/2023 05:27:06 PM


Document Has Been Signed on 06/13/2023 05:27 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:GUERRERO, DOLORESFACILITY NUMBER:
343617821
ADMINISTRATOR:GUERRERO, DOLORESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 422-8234
CITY:SACRAMENTOSTATE: CAZIP CODE:
95822
CAPACITY:14CENSUS: 5DATE:
06/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Dolores Guerrero, LicenseeTIME COMPLETED:
05:40 PM
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On June 13, 2023, an unannounced annual/random inspection was made today by LPA Barragan. Present at time of inspection were licensee and 5 day care children. LPA Barragan spoke with Dolores Guerrero, Licensee.

LPA tour of the home was conducted the inspection, inside and outside, as shown on the facility sketch is conducted. Licensee states there are no weapons or firearms in the home. There was no spas or pools in the home. LPA's observed poisons, cleaning compound's, medications and other hazardous items are inaccessible to children. There was a fireplace in the home, but it is inaccessible to the children. Fire extinguisher, Carbon Monoxide Detector and Smoke Detector meets regulations. Currently, Licensee does have 2 dogs and the Licensee stated that the dogs are not near the children. The Licensee was reminded to ensure safety and appropriate supervision If the dogs are ever near the children. There are no stairs in the home. Toys and play equipment that were observed appeared to be safe. There is a working telephone. Adequate supervision is being provided during this inspection. Children are supervised when outside in any unfenced play area. There was 0 infant under 12 months old present.

The home is a one story home with a front patio, 3 bedrooms, 2 bathrooms, kitchen, day care room, laundry closet, garage, and backyard. The off-limit areas were updated today to: garage, master bedroom, master bathroom, laundry closet, and right side of backyard. Licensee was notified that prior to any changes of an on-limit to an off-limit area, or vice versa, the department must be notified.

Pediatric CPR/FA is current with expiration date of 04/19/2025. A child roster is maintained. Fire and disaster drills have been conducted every six months and documented. Last fire drill was 05/19/2023. Five child's records were reviewed during this inspection.
CONTINUED...
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-5714
LICENSING EVALUATOR NAME: Eduardo BarraganTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2023
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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: GUERRERO, DOLORES
FACILITY NUMBER: 343617821
VISIT DATE: 06/13/2023
NARRATIVE
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LPA's discussed AB 633, Parent Notification Requirements, and the posting of licensing inspection notices and reports. Hours of operation are 5 AM to 6 PM; Monday through Saturday and other hours as arranged. Licensee states she does transport children.

Licensee Dolores Guerrero, 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.

LPA discussed the safe sleep regulations with licensee Dolores Guerrero, Licensee, 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 licensee Dolores Guerrero, 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.


LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.

LPA observed that the licensee and her assistant had not completed the required mandated reporter training. A citation is being administered due to this deficiency. (AB 1207) at website: www.mandatedreporterca.com

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 .No children currently on medication.

SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-5714
LICENSING EVALUATOR NAME: Eduardo BarraganTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: GUERRERO, DOLORES
FACILITY NUMBER: 343617821
VISIT DATE: 06/13/2023
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LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regard to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

To receive important licensed- related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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.

One citation is being administered during this visit.

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 Dolores Guerrero, Licensee.

SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-5714
LICENSING EVALUATOR NAME: Eduardo BarraganTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 06/13/2023 05:27 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: GUERRERO, DOLORES
FACILITY NUMBER: 343617821

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above due to Licensee and her assistant not have mandated reporter training present. Additionally, they received a technical violation they year before, yet hadn't corrected the issue, Which poses a potential health, and safety risk to persons in care.
POC Due Date: 07/13/2023
Plan of Correction
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The Licensee stated that she will ensure that she completes her mandated reported training for assistant and herself by 07/13/2023. The Licensee will email the LPA Barragan the proof of completion of this course. LPA Barragan's email is Eduardo.Barragan@dss.ca.gov
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: Natalie DunawayTELEPHONE: (916) 263-5714
LICENSING EVALUATOR NAME: Eduardo BarraganTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2023
LIC809 (FAS) - (06/04)
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