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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617856
Report Date: 02/28/2020
Date Signed: 02/28/2020 10:51:39 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:JAUREGUI, MARCELINAFACILITY NUMBER:
343617856
ADMINISTRATOR:JAUREGUI, MARCELINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 689-7341
CITY:SACRAMENTOSTATE: CAZIP CODE:
95828
CAPACITY:14CENSUS: 7DATE:
02/28/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Marcelina JaureguiTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Kelly met with licensee at 9:30am for an Annual random inspection. At 9:35am. LPA observed 7 day care children present with licensee's assistant in the play room, these include 3 infants.
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Off-limit areas: Entire second floor, and garage
Today, the home was inspected inside and out and the following was observed by LPA:
-Knives, medications, first aid kit, and cleaning compounds were inaccessible to the children.
-LPA observed a working Smoke, and a Carbon Monoxide detectors, and a fully charged 3-A-10BC fire extinguisher
-Current CPR/First Aid certificate for licensee and her assistant.
-Backyard is fenced, there is a Jacuzzi in the backyard that it's empty of water with a cover with locks and a chain across the middle of cover with locks that have a key, there is also a trampoline in the backyard and licensee stated she does uses it for the day care children and she acknowledges she will use it in accordance with the manufacturer instructions for safety. Sliding door leading to backyard has a safety lock.
-The toys appear to be safe and in good condition
-All sharp knives are stored out of reach
-Stairs are blocked
-Licensee stated there are no weapons/firearms in the home
-All adults in the home are fingerprint cleared
-Cleaning compounds are stored out of reach of children
-The bathroom was free of any hazardous items
-Medication are out of reach of children
-Posted license, parents rights, and emergency disaster plan
-LPA reviewed children's record, roster and fire drills documentation
--LPA discussed and reviewed Health & Safety code: 1597.622 Employees or volunteers at family day care home; immunization requirements; records; exemptions with licensee. 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 and the ADA, available at: http://www.ada.gov/childqanda.htm
-There is a working telephone in the home
-LPA did not observed children alone in parked cars
-Provided licensee with website www.ccld.ca.gov to obtain forms and Title 22 Regulations.

There were no deficiencies cited during inspection.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Socorro KellyTELEPHONE: (916)216-7792
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2020
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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