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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393616496
Report Date: 06/05/2019
Date Signed: 06/05/2019 02:29:56 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:AGUILAR, CRISTIANEFACILITY NUMBER:
393616496
ADMINISTRATOR:AGUILAR, CRISTIANEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 594-3945
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:14CENSUS: 8DATE:
06/05/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Cristiane Aguilar TIME COMPLETED:
02:46 PM
NARRATIVE
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Licensing Program Analyst (LPA) Stacey Williams met with Cristiane Aguilar. licensee for an unannounced random annual inspection. There were eight (8) children present during the inspection. Licensee's assistant was present during the inspection. Licensee's mother was also in the home. Licensee informed LPA her mother is visiting due to the birth of her child and will be leaving the home two weeks. All adults who reside and work in this facility have criminal record clearances. LPA toured areas of the home accessible to children in care. Off-limit areas include: all bedrooms aside from the day-care room and the spare bedroom, the kitchen and laundry room. Effective today, 6/5/19 Licensee will make the entire backyard off limits. Licensee stated the day-care children will be taken to the park for outdoor play.

LPA observed fire drills were conducted within the last six months. LPA reviewed CPR/First Aid certification which expires June 2019. LPA reviewed licensee's and staff files, and a random sample of children files. Licensee did not have immunization records on file for MMR, and TDAP immunization's. LPA toured the home. Licensing posting requirements were posted on the wall in the day-care room. Hazardous items and cleaning supplies were inaccessible to children. Medications are inaccessible to children and kept in licensee's bedroom which is off limits. Licensee stated there are no weapons in the home. Fire extinguisher and smoke detector meet regulation standards. Carbon monoxide detector was operable. LPA observed a wood burning fireplace located in the living room . The fireplace is screened and barricaded. LPA toured the outside of the home and observed rusty nails exposed in areas of the fence. Side fencing is also unsteady and appeared to be leaning. Licensee stated the backyard will be off limits effective today, June 5, 2019. Licensee will contact LPA when backyard meets regulatory standards to obtain clearance to be on limits.

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.

Report continues on the following page, LIC 809C
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey WilliamsTELEPHONE: (916) 216-7797-
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019
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 4
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: AGUILAR, CRISTIANE
FACILITY NUMBER: 393616496
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/05/2019
Section Cited
HSC
1596.8662(b)(1)
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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
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Licensee stated that she will provide proof of mandated reporter training for herself and assistant by POC Date: 7/5/19
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This requirement was not met as evidenced by: LPA reviewed licensee and staff files and did not observe mandated reporter training for licensee or her assistant. This may pose a potential risk to the health and safety of children in care.
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Type B
07/05/2019
Section Cited
HSC
1597.622(c)
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The family day care home shall maintain documentation of the required immunization or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home.
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Licensee stated she shall submit proof of immunization for TDAP and MMR by POC date. Licensee shall maintain documentation of immunization for herself and staff in the facility. Proof of correction shall be sent to LPA by POC date: 7/5/19.
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This requirement was not met as evidenced by: LPA reviewed licensee's file and did not observe TDAP or MMR immunization records. This may pose a potential risk to the health and safety of children in care.
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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: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey WilliamsTELEPHONE: (916) 216-7797-
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: AGUILAR, CRISTIANE
FACILITY NUMBER: 393616496
VISIT DATE: 06/05/2019
NARRATIVE
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Mandated Reporter Training was not viewed in licensee or her assistant's file. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. In addition, existing licensees must meet requirements by March 30, 2018. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: HTTP://WWW.MANDATEDREPORTERCA.COM

Title 22 deficiencies cited on subsequent page, LIC 809D.

This facility evaluation report was reviewed and discussed with licensee. A notice of site visit was provided and should remain posted for 30 days for parental review. LPA encouraged licensee to review the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. The implementation of AB 2370, lead exposure in Family Child Care Homes and proposed safe sleep regulations was discussed. A copy of this report will remain on file for a period of 3 years for public review upon request. Appeal rights were discussed and provided to licensee.
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey WilliamsTELEPHONE: (916) 216-7797-
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: AGUILAR, CRISTIANE
FACILITY NUMBER: 393616496
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/05/2019
Section Cited
CCR
102417(g)
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Operation of a Family Childcare Home:
The home shall be free from defects or conditions which might endanger a child. :
This requirement was not met as evidenced by: LPA toured the backyard of the childcare home and observed rusty nails exposed in areas of the fence. Side fencing is also unsteady and appeared to be leaning.
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Licensee stated she will make the backyard off limits effective today, June 5, 2019. Licensee will make necessary repairs to the fence and notify LPA when repairs have been made. POC date: 7/5/19.
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This poses a potential risk to the health and safety of children in care.
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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: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey WilliamsTELEPHONE: (916) 216-7797-
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4