343623687-12-10-2020-03-CC-KGUA-BW6SZZ-20201210131958

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623687
Report Date: 09/04/2020
Date Signed: 12/10/2020 01:20:06 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:	PINO, CORAZON		FACILITY NUMBER:	343623687
ADMINISTRATOR:	PINO, CORAZON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 491-0215
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95831
CAPACITY:	14	CENSUS:	DATE:	09/04/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Corazon Pino		TIME COMPLETED:	04:30 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	At 3:30 p.m. on Friday, September 4th, 2020, Licensing Program Analyst (LPA) Karyn Guerra met with Licensee, Corazon Pino for the purpose of a pre-licensing inspection for a change of location. A tele-inspection was conducted due to COVID-19. Licensee's daughter was also present during inspection. Licensee was previously licensed at facility #34362368. All individuals subject to criminal background review have obtained a criminal record clearance. An approved fire clearance is on file at the department for the large family child care home. The two story home consists of 4 bedrooms, 3 bathroom, kitchen, living room and formal dining room. Off limits area will consist of Master Bedroom, Garage, and Patio. Applicant acknowledges that children must never enter the off-limits area. Hours of operation are 7:00 a.m.-6:00p.m, Monday thru Friday. Applicant understands they must live in the home and be present at the facility for 80% of operating hours. Applicant guided LPA on a tour of the apartment home. LPA observed functioning smoke and carbon monoxide detectors, and a 2A10-BC fire extinguisher. There is an electric fireplace in the home that applicant stated has been turned off. Applicant guided LPA on a tour of the home. Applicant stated that all hazardous items are inaccessible to children. Applicant stated that there are no firearms nor poisons in the home. The backyard of the property faces a community lake. Community lake has some fencing around it. Applicant has installed wrought iron fencing to fully enclose backyard of facility. There is a wooden portion of fencing with a gate that leads out to the side/front of the facility. Gate swings away from the body of water. All fencing is at least 5 feet tall and is not climbable. Report continues on 809-C.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 216-7796
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2020

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: PINO, CORAZON	FACILITY NUMBER: 343623687
	VISIT DATE: 09/04/2020

NARRATIVE

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Applicant has completed the required Preventative Health and Safety course which includes 1 hour of nutrition. Applicant has current EMSA certified CPR and First Aid certification, expiring 08/2022. AB1207 Mandated Reporter training is current, expiring 8/2022.

Licensee was encouraged to visit the Department’s website at www.cdss.ca.gov for more information regarding child care updates, forms, regulations and legislation. LPA will email this report to Licensee. Acknowledgment of delivery of report constitutes acknowledgement of receipt, in lieu of signature.

As of today, Friday 9/4/2020, the change of location is approved for the licensee to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child is 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. When there is no assistant present, then it will revert back to the small capacity.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 216-7796
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2020

LIC809 (FAS) - (06/04)

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