343623609-7-30-2020-03-CC-KGOL-BRZT5T-20200730142604

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623609
Report Date: 07/30/2020
Date Signed: 07/30/2020 02:26:12 PM

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:	GARCIA, NATALIE		FACILITY NUMBER:	343623609
ADMINISTRATOR:	GARCIA, NATALIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 203-1949
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95838
CAPACITY:	14	CENSUS:	DATE:	07/30/2020
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Natalie Garcia		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Kristal Goodell met with applicant, Natalie Garcia for the purpose of a Change of Location Inspection via Facetime due to COVID-19 closures. All individuals subject to criminal background review have obtained a criminal record clearance. The facility hours of operation will be Monday - Friday, 7:00am - 5:00pm. Applicant acknowledged Child Care shall be provided in the providers own home, for periods of less than 24 hours a day, while the parents are away. No weapon. LPA toured the facility inside and out. The two story home has unfenced front yard, 4 bedrooms, 2 1/2 bathrooms, 2 living rooms, laundry garage and kitchen. The off-limit areas entire upset stairs and garage. Off-limit area will remain inaccessible to children by closed doors and/or supervision. LPA observed parent board with required postings. Toxic and hazardous items are inaccessible to children. Applicant acknowledged that under 102417(4)(A) and (C) the storage areas for poisons, firearms and other dangerous weapons shall be locked. Functioning smoke and carbon monoxide detectors and a 2-A:10-B:C fire extinguisher were observed. Current pediatric CPR and first aid training were verified and expires 12/2021. Proof of 8 hour Preventative Health and Safety was also verifieds in the home or bodies of water. Supervision was discussed, and applicant understands that children must be 100% supervised in unfenced yards. Immediate Civil Penalty regulation and deficiencies were reviewed. Reporting Requirements were also discussed. Report continues on LIC 809-C

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kristal Goodell	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2020

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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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: GARCIA, NATALIE	FACILITY NUMBER: 343623609
	VISIT DATE: 07/30/2020

NARRATIVE

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Records, postings and reporting requirements were discussed. The Records To Be Maintained At The Facility - Family Child Care Home (LIC311D) was issued and discussed. Applicant was encouraged to visit the department website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, self-assessment guides, regulations and legislation pertaining to family child care homes. COVID-19 postings and assessment guide were also issued and discussed. This facility evaluation report was discussed and mailed to applicant for signature due to COVID-19.

Effective today 7/31/20, facility will be approved for a Large family child care home to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of 2 years old.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kristal Goodell	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2020

LIC809 (FAS) - (06/04)

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