553623119-9-8-2021-53-CC-ASRN-C6NSSP-20210908140817

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 553623119
Report Date: 09/08/2021
Date Signed: 09/08/2021 02:08:28 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:	VACA, DEBBIE		FACILITY NUMBER:	553623119
ADMINISTRATOR:	VACA, DEBBIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 532-0899
CITY:	SONORA	STATE: CA	ZIP CODE:	95370
CAPACITY:	14	CENSUS: 10	DATE:	09/08/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:51 AM
MET WITH:	Debbie Vaca		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	On 09/08/21 Licensing Program Analysts (LPA) Aruna Sridharan and Stacey Williams met with licensee Debbie Vaca for unannounced annual inspection. LPA followed infection control protocols. The hours of operation are 3:30am to 6:00pm Monday through Friday. The family child care home facility is two story single family home with four bedrooms in the upstairs and one bedroom, bathroom, living room, kitchen and garage in the first floor. Today's census was three infants and seven preschoolers. The daycare is conducted in the basement with kitchen and bathroom. Off limit areas: Entire upstairs, garage and shed in the backyard. Licensee acknowledges that children may never enter these off-limit areas. The backyard is fenced. Licensee was notified that prior to use of any off limits area, the department must be notified. A tour of the home, inside and outside, as shown on the facility sketch was conducted. The house has a working telephone, fully charged fire extinguisher, smoke detector and carbon monoxide detector that meet regulations. The first aid kit is located in the daycare closet. As per the licensee, there are no firearms or weapons in the home. LPA observed cleaning compound's under the bathroom sink with child safety latch. Licensee informed that she does not provide overnight care. Safe toys and play equipment are observed. LPA observed all the required postings, reviewed all staff and childrens records. LPA discussed the Safe Sleep regulations. LPA observed the record of licensee’s immunization on file. LPA reviewed children's roster and fire drill log last conducted on 06/11/21. LPA requested a copy of children's roster from the licensee. Licensee had CPR/First aid card that expires on 02/23 and Mandated Reporter AB 1207 that expires on 06/23.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna Sridharan	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

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: VACA, DEBBIE	FACILITY NUMBER: 553623119
	VISIT DATE: 09/08/2021

NARRATIVE

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LPA discussed the California Child Care Worker: Mandated Reporter Training with the licensee. The licensee must complete the training every two years starting January 1, 2018 and retain proof of completion in the facility file. The training can be found at: mandatedreporterca.com.

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

This facility evaluation report was reviewed and discussed with the applicant. Records, postings and reporting requirements were discussed. Applicant was encouraged to visit the department website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to family child care homes.

LPA advised the facility to follow all the Covid precautions while providing care for children.

No Title 22 Deficiencies observed in the areas of today's facility evaluation. LPA reviewed report with the Licensee and provided copies. An exit interview was conducted. Appeal rights provided. Notice of Site Visit was provided, and licensee understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna Sridharan	TELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2021

LIC809 (FAS) - (06/04)

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