394500430-6-18-2021-53-CC-CJAN-C44P3B-20210618105715

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500430
Report Date: 06/18/2021
Date Signed: 06/18/2021 10:57:23 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:	TRUJEQUE, BRIANA		FACILITY NUMBER:	394500430
ADMINISTRATOR:	TRUJEQUE, BRIANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 356-8837
CITY:	MANTECA	STATE: CA	ZIP CODE:	95337
CAPACITY:	14	CENSUS: 2	DATE:	06/18/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Briana Trujeque		TIME COMPLETED:	11:15 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	Licensing Program Analyst (LPA) Christopher Jackson met with the applicant Briana Trujeque for the purpose of a change of location inspection. LPA toured the whole home inside and out for a health and safety inspection. The single story home consists of a front play room, front bathroom, kitchen, family room, garage, laundry room and three bedrooms and two additional bathrooms towards the rear of the house. Also present during today's inspection was applicants two children and father. All adult residents have obtained a criminal record clearance from the department. Off-limit areas include: The three back bedrooms, bathroom located in hall area near bedrooms, laundry room and garage. Applicant understands that children may never enter these off-limit areas. LPA observed a fire extinguisher, carbon monoxide detector and smoke detector that meet regulation. Hazardous cleaning compounds and medications are stored inaccessible or out of reach for children in care. LPA observed the backyard is fenced and there are no bodies of water on the property. LPA discussed that 100% supervision is required in any unfenced areas. Applicant rents the home and provided a copy of the rental agreement for the home. LPA explained the option of obtaining $300,000 liability insurance. Applicant stated that a policy has been obtained. The applicant is applying for a large family home day care. A copy of the approved fire clearance from the Manteca Fire Department was obtained on 06/10/21 clearing the home. LPA provided the applicant with the community care licensing website (www.ccld.ca.gov) to access updated forms, and stay current on any changes to laws and regulations. LPA discussed with licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov. LPA discussed applicant needs to notify licensing for any modifications done to the home, inside and outside. LPA observed posted Emergency Disaster Plan and Parents' Rights Poster. 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: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

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: TRUJEQUE, BRIANA	FACILITY NUMBER: 394500430
	VISIT DATE: 06/18/2021

NARRATIVE

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During today's inspection LPA discussed with applicant the requirement for licensees to provide proof of completion for the Lead Exposure training. LPA informed applicant a provisional license will be granted, but applicant must complete the Lead training for final licensure. Applicant registered for the training during today's inspection and will provide LPA with proof of completion certificate once training is finalized.

LPA discussed fire drills to be conducted at least once every six months. Applicant stated there are no weapons in the home. LPA discussed the infant sleep regulations with applicant. LPA explained infants 12 months and under must have the LIC 9227, infant sleep plan on file. In addition LPA explained that 15 minute checks must be done on all infants 24 months and under during their nap time. LPA provided appliicatn with a copy of LIC 9227. During the inspection LPA reviewed COVID19 practices and conducted a technical assistance tour of the facility to incorporate Department of Public Health safety protocols for operating during the pandemic. LPA discussed posting requirements and facility operations including sanitation and pick up/drop off procedures.

As of 06/18/2021 a provisional license will be granted for 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 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.

Licensee must provide proof of completion for the Lead component training to LPA within 90 days.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2021

LIC809 (FAS) - (06/04)

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