393610469-3-3-2023-53-CC-ESIA-CPKPF5-20230303101611

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393610469
Report Date: 03/03/2023
Date Signed: 03/03/2023 10:16:15 AM

Document Has Been Signed on 03/03/2023 10:16 AM - 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, IDALIA		FACILITY NUMBER:	393610469
ADMINISTRATOR:	CAMARILLO, IDALIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 922-4993
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95209
CAPACITY:	14	CENSUS: 7	DATE:	03/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Idalia Camarillo		TIME COMPLETED:	10:40 AM

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On 03/03/23, Licensing Program Analyst (LPA) Elvira Sierra met with the Licensee, Idalia Camarillo for the purpose of an unannounced annual inspection. Facility hours of operation are M-F from 06:00am to 06:00pm. A review of the Facility Personnel Summary shows that all adults living and working in the home have criminal record clearances on file with Licensing Office. Licensee stated that no new adult residents moved into the home since licensure. Present in the facility was Licensee and assistant caring for 7 children.

A health and safety inspection was conducted in all areas accessible to children. Off limit areas are: Living room, kitchen, dining area, bedroom # 2, master bedroom (bathroom # 2 inside master bedroom), garage, front yard, left and back side of the backyard, two storage sheds, and the turtle house pin. Licensee was reminded that day care children may never enter these off-limit areas. LPA observed the posting of the facility license, Emergency Disaster Plan, Earthquake Preparedness Checklist and Notification of Parent Rights by the main entrance of the home. LPA observed the home was clean and appropriately ventilated. Facility maintains a working phone, 2A10BC fire extinguisher, and functioning smoke/carbon monoxide detectors. Licensee stated there are no weapons in the home. No bodies of water were observed on the premises. Toxic and hazardous items are inaccessible to children. Medications are kept off limit to the children. The fireplace in the living room is appropriately barricaded and is off limits. Licensee stated the backyard is not being used right now because of the bad weather. LPA advised Licensee to make sure that backyard is free of any debris or dangerous condition once she is getting ready to use the backyard. t.

One staff file and five children files were reviewed and files are completed containing all the documents required by regulation. Sleeping logs for infant in care was reviewed. Licensee CPR expires on 06/17/24. Mandated Reporter training certificate was observed and expires on 01/04/25. LPA provided PIN 20-24 Recently approved safe sleep regulations in effect, Safe Sleep Regulation Concep

Report continues on subsequent page 809C-

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

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: CAMARILLO, IDALIA	FACILITY NUMBER: 393610469
	VISIT DATE: 03/03/2023

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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

LPA discussed the safe sleep regulations 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. LPAs also informed licensee 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. 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

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

Exit interview was conducted. This report and Appeal of Rights were reviewed and provided to the Licensee, Idalia Cmarillo. A notice of site visit was posted and must remain posted for 30 days.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2023

LIC809 (FAS) - (06/04)

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