344500085-8-20-2019-53-CC-ASIA-BF8P9P-20190820110727

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 344500085
Report Date: 08/20/2019
Date Signed: 08/20/2019 11:07:35 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:	MENDOZA, ALMA		FACILITY NUMBER:	344500085
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	08/20/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Alma Mendoza		TIME COMPLETED:	11:20 AM

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	Alma Mendoza is Spanish speaking and Licensing Program Analyst Marissa Soto spoke with Alma Mendoza in Spanish, and have translated the conversation to English below. Licensing Program Analysts (LPAs) Amy Silva and Marissa Soto met with applicant, Alma Mendoza, for the purpose of a pre-licensing inspection. All individuals subject to criminal background review have obtained a criminal record clearance. A health and safety inspection were conducted inside and out. The one story home has four bedrooms, two bathrooms, a living room, dining room, kitchen, garage, laundry room and fenced backyard. The off-limits areas in the home are all bedrooms, laundry room and garage. Off-limits areas will remain inaccessible to children by closed doors and/or supervision. Hours of operation will be 3:00 AM to 2:00 AM; Monday thru Sunday and other hours as arranged. Licensee will transport children when needed. Toxic and hazardous items are inaccessible to children. Functioning smoke and carbon monoxide detectors and fire extinguisher were observed in the home. Preventative, pediatric CPR and first aid training were verified and current. No weapons in the home. The fireplace in the home is a decorative fireplace, which doesn't produce heat. Supervision was discussed, and applicant understands that children must be 100% supervised in unfenced yards. Immediate Civil Penalty regulation and deficiencies were reviewed. LPAs consulted applicant regarding the following topics; new upcoming regulations, Type A vs. Type B deficiencies, complaints, LPA’s right to interview children without parental consent, civil penalties, incidental medical services, placement of detergents, placement of poisons, placement of medicines, announced vs. unannounced inspections, posting requirements, unusual incident reports, On-limits vs. Off-limit areas, licensing file management, fire drills, 80% supervision, 100% supervision, fingerprint clearances, advertising, mandated reporting and best practices. Report continues on LIC809C

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

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: MENDOZA, ALMA	FACILITY NUMBER: 344500085
	VISIT DATE: 08/20/2019

NARRATIVE

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LPAs consulted the applicant regarding personal rights. Applicant understands that corporal, physical and/or unusual forms of punishment is never allowed toward day care children or their own children during day care hours.

LPAs reviewed with licensee the handouts “A Child Care Provider’s Guide to Safe Sleep” and “Safe Sleep Regulation Concepts” and "Lead Poisoning Facts" and gave her a copy of these handouts.

LPAs provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPAs advised licensee of their responsibility to stay current in regards to new regulations. LPAs also included the email address for the children's advocacy program to stay current on new laws CHILDCAREADVOCATESPROGRAM@DSS.CA.GOV.

Incidental Medical Services (IMS) was discussed with Licensee understands if she decideds to provide IMS services, she must have an IMS plan. 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

Effective today 8/20/19, License for small family child care home approved today.
Facility is approved for a small family child care home license to serve a capacity of 6 children with no more than 3 infants or 4 infants only. Or with a capacity of 8 children: no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6. An exit interview was conducted and notice of site visit was posted.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2019

LIC809 (FAS) - (06/04)

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