393614269-3-27-2023-53-CC-TDIP-CQBURY-20230327154932

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393614269
Report Date: 03/27/2023
Date Signed: 03/27/2023 03:50:03 PM

Document Has Been Signed on 03/27/2023 03:50 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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	MARQUEZ, ROMELIA		FACILITY NUMBER:	393614269
ADMINISTRATOR:	ROMELIA MARQUEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 825-0699
CITY:	MANTECA	STATE: CA	ZIP CODE:	95337
CAPACITY:	14	CENSUS: 5	DATE:	03/27/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Romelia Marquez		TIME COMPLETED:	04:00 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 03/27/2023 at 1:15 PM, Licensing Program Analysts (LPAs) Tiffanie Diep and Lauren Scott met with Licensee, Romelia Marquez, for the purpose of an unannounced annual inspection. There were five children present at the time of inspection. Licensee's operating hours are Monday through Friday from 4:30 AM to 6:00 PM. 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. A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the garage, laundry room, office, entire second floor, and pool. LPAs observed the required postings and a working phone. 3A10BC fire extinguisher meets regulations. LPAs observed smoke and carbon monoxide detectors and verified they were both functional. LPAs toured the kitchen area and verified knives were inaccessible to children in care. LPAs observed playroom area with age-appropriate toys for children. LPAs observed a bathroom and verified that hazardous and toxic items were inaccessible to children in care. LPAs observed a fireplace that was barricaded by a glass screen. Licensee stated there are no weapons in the home. The backyard has an in-ground pool area that is fenced according to Title 22 Regulations and LPAs observed the gate to self-close and self-latch. LPAs walked the perimeter of the outdoor play area during inspection and verified that the entire area is fenced in. Continues on 809-C

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Tiffanie Diep	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MARQUEZ, ROMELIA	FACILITY NUMBER: 393614269
	VISIT DATE: 03/27/2023

NARRATIVE

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Children's files were reviewed. Emergency information and required immunization records were on file. LPAs observed a current roster and documentation that a fire drill is conducted at least once every six months. Licensee's immunization records are available in the facility file. Current EMSA pediatric CPR and First Aid certification was discussed and expired 10/2022. Licensee was reminded to renew the course every two years. Child Care Provider Mandated Reporter certification was verified and expires 04/2023.

LPAs 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. 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. LPAs discussed the requirement to check and log infant napping every 15 minutes for infants 24 months and under. LPAs discussed the requirement of the LIC 9227, Individual Sleeping Plan, for infants under 12 months.

Incidental Medical Services (IMS) policy was discussed. For IMS information, see PIN 22-02-CCP. 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

Continues on 809-C

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Tiffanie Diep	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MARQUEZ, ROMELIA	FACILITY NUMBER: 393614269
	VISIT DATE: 03/27/2023

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive e-mail communication. Licensee was encouraged to visit the Department’s website at http://ccld.ca.gov/ for information regarding child care updates, forms, regulations and legislation pertaining to Family Child Care Homes.

To improve the quality and value of the new inspection process, a survey will be sent to the e-mail 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 e-mail 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/inspection-process.

In the areas that were evaluated, a deficiency is being cited on the attached LIC 809-D during today’s inspection.

An exit interview was conducted and report was reviewed with the licensee, Romelia Marquez. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Tiffanie Diep	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/27/2023 03:50 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MARQUEZ, ROMELIA	FACILITY NUMBER: 393614269
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/27/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as their CPR/first aid certificate expired on 10/2022 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/27/2023
	Plan of Correction
1 2 3 4	Licensee will provide proof of enrollment and completed certificate to LPA by 04/27/2023

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Tiffanie Diep	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023

LIC809 (FAS) - (06/04)

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