573616050-12-3-2021-53-CC-CHUR-C9CV6Z-20211203151022

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 573616050
Report Date: 12/03/2021
Date Signed: 12/03/2021 04:19:19 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:	TAMAYO, LETICIA		FACILITY NUMBER:	573616050
ADMINISTRATOR:	TAMAYO, LETICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 419-1370
CITY:	WOODLAND	STATE: CA	ZIP CODE:	95776
CAPACITY:	14	CENSUS: 0	DATE:	12/03/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Facility Representative		TIME COMPLETED:	03:35 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 December 3, 2021 at 2 PM, Licensing Program Analysts (LPAs) Chayntel Hunter and Elvira Sierra met with Licensee's daughter for the purpose of an unannounced annual inspection. There were no children present at the time of inspection. Licensee was not present during the inspection, but was available via telephone. Licensee's operating hours are Monday through Friday from 7 AM. to 5 PM. LPA verified the annual fees are current. Facility representative 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 entire upstairs and the garage. Off limit areas are being made inaccessible by closed locked doors and baby gates. LPAs observed the required postings and a working phone. 2A10BC fire extinguisher meets regulations. LPAs observed smoke and carbon monoxide detectors, and verified they were both functional. LPAs toured the kitchen area and verified knives and cleaners were inaccessible to children in care. Facility representative stated there are no weapons in the home. There are no bodies of water on the premises. Outdoor play space is fenced. LPAs observed living room area with age appropriate toys for children. LPAs observed a restroom and verified that hazardous and toxic items were inaccessible to children in care. Children's files were reviewed. Emergency information and required immunization records were on file. LPAs observed a current roster. Licensee's immunization records for measles (MMR), pertussis (Tdap), and the flu are available in the facility file. Current in-person EMSA pediatric CPR and First Aid certification was verified and expires 10/17/2022 and Child Care Provider Mandated Reporter certification was discussed. Report continues on 809-C.

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2021

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: TAMAYO, LETICIA	FACILITY NUMBER: 573616050
	VISIT DATE: 12/03/2021

NARRATIVE

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LPA discussed the safe sleep regulations with Facility representative 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 Facility representative 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.

In addition, LPAs discussed the infant sleep regulations with licensee. LPAs discussed the requirement to check and log infant napping every 15 minutes for infants 24 months and under. LPAs provided a copy of LIC 9227 Individual Sleeping Plan, for infants under 12 months, for licensee during today's inspection.

This provider is not currently providing IMS services to children in care. 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

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 facility representative. A Notice of Site Visit was given and must remain posted for 30 days for parental review.

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2021

LIC809 (FAS) - (06/04)

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