<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393610469
Report Date: 04/25/2022
Date Signed: 04/25/2022 12:22:02 PM


Document Has Been Signed on 04/25/2022 12:22 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833



FACILITY NAME:CAMARILLO, IDALIAFACILITY NUMBER:
393610469
ADMINISTRATOR:CAMARILLO, IDALIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 922-4993
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY:14CENSUS: 7DATE:
04/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Idalia CamarilloTIME COMPLETED:
12:35 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
On Monday, April 25, 2022, at 09:15 am, Licensing program Analyst (LPA) Elvira Sierra met with the licensee, Idalia Camarillo for the purpose of an unannounced annual inspection. Present in the facility were Licensee, two assistants and seven daycare children. All individuals subject to criminal background review have obtained a criminal record clearance. Facility hours of operation are M-F from 07:00 am to 06:00 pm.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include; Living room, kitchen, dining area, bedroom # 2, master bedroom (bathroom # 2 inside master bedroom), garage, front yard, fenced left and back side of the backyard, two sheds, and the turtle house pin. Upon entry, LPA observed the required postings; License, Emergency Disaster Plan, Earthquake Preparedness Checklist and Notification of Parent Rights. Facility maintains a working phone, and a 2A10BC fire extinguisher. Homes was appropriately ventilated and age appropriate toys and reading material were observed. Toxic and hazardous items were inaccessible to children. There are no bodies of water on the premises. Weapons in the home are stored according to Title-22; LPA observed weapon and ammunition stored and locked in a separate safe inaccessible to children. Outdoor play area is free from defects or dangerous conditions and fenced for supervision.

Licensee provide meals to the children. First Aid Kit is fully stocked and accessible. Licensee last emergency drill was conducted on 03/03/22 and was properly logged.
Staff and 2 children’s were reviewed and are complete. LPA observed a current roster. The licensee's immunization records for measles (MMR), pertussis (Tdap), and the flu are available in the facility file. Licensee in person EMSA CPR and First Aid certification was verified and expires on 06/16/22 and AB 1207 Mandated Reporter Training was verified and expires 01/31/24.

Report continues on subsequent page 809C--
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2022
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: CAMARILLO, IDALIA
FACILITY NUMBER: 393610469
VISIT DATE: 04/25/2022
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
26
27
28
29
30
31
32
LPA verified the annual fees are current. Licensee 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.

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



LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
A Notice of Site Visit was given and must remain posted to the interior side of the main door for 30 days. LPA posted the Notice of Site Visit on today's inspection.

Exit interview conducted and report was reviewed with the Licensee.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/25/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2