393621338-10-21-2021-53-CC-ESIA-C7ZQRH-20211021122357

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393621338
Report Date: 10/21/2021
Date Signed: 10/21/2021 12:24:06 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:	MADRIAGA, NORMA		FACILITY NUMBER:	393621338
ADMINISTRATOR:	MADRIAGA, NORMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 981-2313
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95209
CAPACITY:	14	CENSUS: 2	DATE:	10/21/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Norma Madriaga		TIME COMPLETED:	12:40 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 Thursday October 21, 2021, at 09:25 am Licensing Program Analyst (LPA) Elvira Sierra met with license's assistant, Michelle Parado for the purpose of an unannounced annual random inspection. Licensee arrived later during the inspection. Facility hours of operation are 7 days a week from 06:00 am to 11:30 pm. Capacity specified on the license was met on today’s inspection. Upon arrival present in the facility was Licensee's assistant caring for 2 daycare children.. A health and safety inspection was conducted in all areas accessible to children. Off limit areas are:Two downstairs bedrooms, laundry room, entire upstairs, and garage. LPA reminded Licensee that Emergency Disaster Plan, Earthquake Preparedness Checklist and Notification of Parent Rights must be posted in a visible area to parents and/or visitors during daycare hours. Facility maintains a working phone, and functioning smoke/carbon monoxide detectors. Per Licensee there are no weapons in the home. There are no bodies of water on the premises. Toxic and hazardous items are inaccessible to children. Fireplace is barricaded. Outdoor play space is fenced for supervision and is free from any dangerous conditions. Children's files were not available for review. Current in person EMSA CPR and First Aid certification was verified for staff and Licensee. Licensee's CPR expires on 03/14/2022. Fire drills are conducted at least every six months. 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. Report continues on page 809C....

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021

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: MADRIAGA, NORMA	FACILITY NUMBER: 393621338
	VISIT DATE: 10/21/2021

NARRATIVE

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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

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. 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 10/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021

LIC809 (FAS) - (06/04)

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