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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618862
Report Date: 01/06/2020
Date Signed: 01/06/2020 11:08:44 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:MEJIA, JUANAFACILITY NUMBER:
343618862
ADMINISTRATOR:MEJIA, JUANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 359-3350
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY:14CENSUS: 3DATE:
01/06/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
07:10 AM
MET WITH:Juana MejiaTIME COMPLETED:
08:35 AM
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Licensing Program Analyst (LPA) Christopher Bello met with licensee Juana Mejia for an unannounced random annual inspection and toured areas of the home accessible to children in care. Off-limit areas include all bedrooms and garage. Licensee acknowledged that children may never enter these off-limit areas. The census included three children. Also present was licensee’s husband who was acting as her assistant. Licensee stated there are no new residents in the home since licensure. All Adult residents have criminal record clearances.
LPA observed current CPR/First Aid certificates which expire on 9/2020. LPA discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed some children’s files and observed that the licensee was using the past required county forms. LPA printed and provided a copy of the State required children’s forms. LPA observed fire drills were conducted at least once every six months and documented. LPA notified licensee of upcoming safe sleep and lead testing regulations.
LPA observed that there were no hazardous items accessible to children. LPA observed Fireplace which was screened. LPA observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Fire extinguisher, smoke detector and carbon monoxide detector meet regulation. Toys appear to be safe. The backyard is fenced and gated.
There are no bodies of water observed.
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.

REPORT CONTINUES ON NEXT PAGE.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: MEJIA, JUANA
FACILITY NUMBER: 343618862
VISIT DATE: 01/06/2020
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LPA checked facilities fees and confirmed that it is up to date.
LPA provided the Community Care Licensing’s 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 regards to new regulations.

LPA advised licensee to sign up for the quarterly updates provided by the Childcare Advocates Program. LPA provided the link https://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe for the licensee to sign up for the updates.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the director and provided copies. An exist interview was conducted. LPA observed the Notice of Site Visit posted and the director understands it must remain posted for 30 days.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher BelloTELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2020
LIC809 (FAS) - (06/04)
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