394500188-3-30-2022-53-CC-SMAY-CCZSZU-20220330141943

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500188
Report Date: 03/30/2022
Date Signed: 03/30/2022 02:19:51 PM

Document Has Been Signed on 03/30/2022 02:19 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
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: 5	DATE:	03/30/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Elda Prieto, Licensee		TIME COMPLETED:	02:30 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	Licensing Program Analysts (LPAs) Christopher Jackson and Salene Mayberry met with Licensee, Elda Prieto, 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 7:00 AM. to 5:00 PM. All adults subject to criminal background review have obtained criminal record clearance. 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 two front bedrooms, master bedroom/bathroom, laundry room and back storage. LPAs observed the required postings and a working phone. 3B40BC fire extinguisher meets regulations, and LPAs observed a functional dual smoke and carbon monoxide detector. LPAs toured the kitchen area and verified knives were inaccessible to children in care. LPAs observed a playroom area with age appropriate toys for children. LPAs observed a restroom and verified that hazardous and toxic items were inaccessible to children in care. LPAs observed the weapon in the home to be stored according to Title 22 regulations. There are no bodies of water on the premises. Outdoor play space is fenced. Report continues on 809-C.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022

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: PRIETO, ELDA	FACILITY NUMBER: 394500188
	VISIT DATE: 03/30/2022

NARRATIVE

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Five children's files were reviewed. Emergency information and required immunization records were on file. LPAs observed a current roster. Licensee's immunization records are available in the facility file. Current EMSA pediatric CPR and First Aid certification was verified and expires 03/2024. Licensee could not provide a copy of a current Child Care Provider Mandated Reporter certification or Fire Drill log during today's inspection.

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 discussed the requirement to check and log infants napping every 15 minutes for infants under 24 months. In addition LPAs discussed and provided a copy of the LIC9227 Individual Sleeping Plan, to be completed for infants under 12 months. 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.

This provider is not currently providing Incidental Medical Services (IMS) services to children in care. LPAs discussed the IMS policy and that if in the future IMS is provided, a Plan 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 809-C.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022

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: 03/30/2022

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To improve the quality and value of the new inspection process, a survey will be sent to the email 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 email 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

Exit interview conducted and report was reviewed with the Licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, no deficiencies were cited during today’s inspection.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022

LIC809 (FAS) - (06/04)

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