394500188-3-2-2020-53-CC-CJAN-BMBPRA-20200302103226

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500188
Report Date: 03/02/2020
Date Signed: 03/02/2020 10:32:33 AM

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:	PRIETO, ELDA		FACILITY NUMBER:	394500188
ADMINISTRATOR:	PRIETO, ELDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 321-6709
CITY:	MANTECA	STATE: CA	ZIP CODE:	95337
CAPACITY:	14	CENSUS: 0	DATE:	03/02/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Elda Prieto		TIME COMPLETED:	10:45 AM

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 03/02/20202, Licensing Program Analyst (LPA) Christopher Jackson met with applicant Elda Prieto for a Change of Location inspection. LPA observed zero children in care during the inspection. The applicant moved into a single story home, that consists of two front bedrooms, bathroom, living room, kitchen, laundry room, master bedroom and bathroom to the rear of the home. The front yard is unfenced. LPA discussed 100% supervision if children are in the front yard. There is a fully fenced in yard area. The fenced in yard area has a door that provides direct access to the street area. LPA advised the licensee to maintain supervision with children while outside in the fenced area. The Off limit areas include the two front bedrooms, laundry room, Master bedroom closet, and rear storage area to the back of the outside space. There is also a small apartment on the property. Licensee stated this small in-law unit would be off limits to children in care. LPA observed all areas of the home during today's inspection. LPA observed no bodies of water on the property. Toxins and dangerous items were made inaccessible. During today's inspection LPA observed two infant swings. LPA discussed with licensee safe sleep practices. LPA provided handout on safe sleep information. LPA informed licensee that the swings can be used by infants in care. LPA advised licensee to follow the manufactures instructions. LPA also informed licensee that infants are not to sleep while in the swings. Applicant stated there are no weapons in the home. Applicant’s CPR/First Aid certification expires 11/10/2020. All adults in the home have criminal record clearances. In addition, LPA tested the dual smoke alarm, carbon monoxide detector. LPA observed a fire extinguisher under the kitchen sink that meets Title 22 regulations. A copy of the Fire Clearance was received on 02/20/2020 from the Manteca Fire Department . A copy of has been placed in the applicants file. LPA reviewed licensing forms and provided the licensing website, www.ccld.ca.gov, so applicant may download forms, or review regulations. Report Continues on 809-C

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020

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: PRIETO, ELDA	FACILITY NUMBER: 394500188
	VISIT DATE: 03/02/2020

NARRATIVE

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During today's inspection LPA provided copies of the Safe Sleep Concepts flyer for licensee to review. In addition LPA provided the Effects of Lead Exposure brochure and a copy of the updated immunization record CDPH 286.

Effective today, 03/02/2020, LPA is granting a large family child care license to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children with 1 child in transitional kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of 2 years old.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020

LIC809 (FAS) - (06/04)

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