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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622474
Report Date: 10/06/2022
Date Signed: 10/06/2022 03:06:13 PM


Document Has Been Signed on 10/06/2022 03:06 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:ZAUCHA, JAMILA & ZAUCHA, RUSSELLFACILITY NUMBER:
343622474
ADMINISTRATOR:ZAUCHA, JAMILA & ZAUCHA, RFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 402-5269
CITY:ORANGEVALESTATE: CAZIP CODE:
95662
CAPACITY:14CENSUS: 5DATE:
10/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Jamila ZauchaTIME COMPLETED:
02:40 PM
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Licensing Program Analyst Jennifer Velasco (LPA) conducted an unannounced annual inspection and met with Licensee Jamila Zaucha (L1). LPA observed five children in care with Licensee and an assistant. Facility hours of operation are Monday through Thursday, 7:30 AM to 5:30 PM. LPA observed that the annual facility fees are current.

L1 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.

Off limit areas include: Garage, laundry room, and main bedroom and bathroom. Licensee acknowledged that children may never enter these off-limit areas. LPA conducted a health and safety inspection and observed that the facility is clean, safe, sanitary, and in good repair with ventilation. LPA observed the required documents were posted where visible to parents. LPA observed that there were no hazardous items accessible to children including cleaning compounds, medications, or sharp objects. Fire extinguisher is in working condition and accessible. LPA observed a combined smoke and carbon monoxide detector that is functioning properly. The facility has adequate toys that are safe for children to use. The backyard and front yard are fully fenced. The Licensee stated there are no firearms at the facility. No body of water was observed in the facility.

LPA observed a current children's roster, fire drill log, and safe sleep log. LPA reviewed children’s files and observed that all the required documentation was present in each child's file. LPA observed the CPR/First Aid certificate was current and expires in 2023. LPA observed a current Mandated Reporter certificate for all staff. L1 was reminded the Child Care portion must be completed every two years. LPA reviewed staff and facility files and observed the required documentation.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: 707-953-7341
LICENSING EVALUATOR SIGNATURE:
DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/06/2022
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: ZAUCHA, JAMILA & ZAUCHA, RUSSELL
FACILITY NUMBER: 343622474
VISIT DATE: 10/06/2022
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LPA discussed with L1 the safe sleep regulations and the Child Care Licensing Safe Sleep web page athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed L1 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.

Incidental Medical Services- IMS policy was discussed. 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. LPA discussed current COVID guidelines with Licensee and provided technical assistance.

LPA provided the Department’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 by reviewing PINs on the website.

There were no citations issued during today's inspection. A notice of site visit was given to L1 and must remain posted for 30 days. Exit interview was conducted and report was reviewed with L1.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: 707-953-7341
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
LIC809 (FAS) - (06/04)
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