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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620951
Report Date: 03/02/2022
Date Signed: 03/02/2022 11:10:24 AM


Document Has Been Signed on 03/02/2022 11:10 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:TORRES, ROSAFACILITY NUMBER:
393620951
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
03/02/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Rosa TorresTIME COMPLETED:
11:25 AM
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On Wednesday, March 02,2022, at 09:10 am Licensing Program Analyst (LPA) Elvira Sierra conducted a Case Management visit for the purpose of increasing capacity from 8 to 14 children. LPA met with Licensee, Rosa Torres. Fire Safety Inspection Clearance was granted on 02/18/22 for a total capacity of 14 children. Facility hours of operation are from M-F from 07:00 am to 06:00 pm. All individuals subject to criminal background review have obtained a criminal record clearance. LPA observed 5 children being supervised by Licensee and her assistant. One of the children is Licensee's own child.

At 09:25 am, with the help of the Licensee, a health and safety inspection of all areas accessible to children was conducted and the following was observed. Home appears orderly and suitable for children. Licensee stated she likes to make bedroom # 1 and #2 off limit to the children. Bedrooms # 1 and # 2 are approved as off limit area on today's inspection. Off-limits areas include; All bedrooms, bathroom # 2 (inside master bedroom), kitchen, closet/laundry room, and garage. Licensee acknowledged that children may never enter these off-limit areas. Hazardous items were stored inaccessible to children. Napping equipment and age appropriate toys were observed. Licensee stated there are no weapons and no bodies of water were observed. Home as a working telephone, 2A10BC fire extinguisher and a functioning smoke and carbon monoxide detectors. The backyard is fenced for supervision. Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.



A current CPR/First Aid was verified and expired 07/20/2023 and the Mandated Reporter Training for Licensee and her assistant expires on 01/05/2024. LPA reviewed large family child care home capacity limitations with licensees.

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: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/02/2022
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: TORRES, ROSA
FACILITY NUMBER: 393620951
VISIT DATE: 03/02/2022
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Licensee, was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 safe sleep regulations with licensee, and discussed 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, 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 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



Capacity increase is approved as of today, March 2, 2022. The facility is licensed to serve a MAX. CAP(WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

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. Exit interview conducted and report was reviewed with the licensee, Rosa Torres.

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

DATE: 03/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022
LIC809 (FAS) - (06/04)
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