393613011-3-13-2020-53-CC-ASRN-BMNTQH-20200313145559

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393613011
Report Date: 03/13/2020
Date Signed: 03/13/2020 02:56:33 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:	CANTU, MARIA		FACILITY NUMBER:	393613011
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	03/13/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Maria Cantu		TIME COMPLETED:	03:10 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) Aruna Sridharan met with licensee Maria Cantu and toured areas of the home accessible to the children. Today's census was 5 children which included two infants, one preschooler and two school aged children. The licensee's spouse and mother were present in the home. The facility operates Monday through Friday 6:00am to 8:30pm. Licensee stated there are no new residents in the home, and all adult residents have criminal record clearances. Off-limit areas include the garage and entire upstairs. Licensee acknowledged that children may never enter these off-limit areas. Licensee stated that there are no weapons in the home and LPA observed no bodies of water. An electric fake fireplace is in the living room. Fire extinguisher, smoke detector and functioning carbon monoxide meet regulation. All the required postings were posted in a prominent area in the home. The first aid kit was places in kitchen. LPA observed cleaning supplies, hazardous items and medications are properly stored out of children's reach. LPA observed a fire drill log and current children's roster. Toys appear to be safe and in working order. The backyard is fenced and there is a three tiered water fountain which has rocks on each level. LPA observed current CPR/First Aid certificate that expires 03/09/2021 and Mandated Reporter that expires 03/12/21. Licensee had immunizations on file for self and spouse. LPA observed all 5 children's files and the required forms were duly signed by the authorized representative. Report continues on 809C....

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna Sridharan	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020

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: CANTU, MARIA	FACILITY NUMBER: 393613011
	VISIT DATE: 03/13/2020

NARRATIVE

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LPA also discussed the Incidental Medical Services (IMS) policies with the licensee. The facility is not currently providing IMS. If the licensee plans to provide IMS in the future she can refer to: 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: www.ada.gov/childqanda.htm

LPA also discussed Unusual Incident Reports (UIRs) and reporting requirements. LPA informed the licensee that if any unusual incidents occur she must contact the Department within 24 hours and an UIR must be submitted with 7 days, describing the specifics to the incident.
LPA advised the licensee on Safe Sleep Practices and SIDS; the licensee stated they are understood and practiced. She stated she uses porta cribs for sleeping infants and understand infants cannot sleep in car seats, swings or other items not intended for sleeping.

LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised the licensee that it is her responsibility to stay up-to-date and informed in regards to new regulations.

No Title 22 Deficiencies observed in the areas that were evaluated during today's inspection. LPA read this report to the licensee; she stated that understands today’s inspection. Notice of Site Visit posted and the licensee understands it must remain posted for 30 days. Appeal rights were provided to Licensee.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna Sridharan	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020

LIC809 (FAS) - (06/04)

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