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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093624494
Report Date: 08/25/2023
Date Signed: 08/25/2023 12:02:13 PM

Document Has Been Signed on 08/25/2023 12:02 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:UTRILLA, DANIELLEFACILITY NUMBER:
093624494
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
08/25/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Danielle UtrillaTIME COMPLETED:
12:15 PM
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On August 25th, 2023, Licensing Program Analyst (LPA) Soleil Marx met with Licensee, Danielle Utrilla, for an unannounced annual / one year inspection. During the inspection there was a census of six children in care being supervised by the licensee. All individuals subject to criminal background review have obtained a criminal record clearance. Facilities hours of operation are Monday through Friday 08:30 AM to 04:30 PM.

A health and safety inspection was conducted in the areas accessible to children. The off-limits areas include: master bedroom/bath, laundry room, and shed. Licensee understands that children may never enter these off-limits areas.

LPA observed a working telephone, functioning smoke and carbon monoxide detector, and a 2A10BC fire extinguisher within the home. LPA observed home was safe, orderly, and free of hazards. LPA observed a variety of age-appropriate toys within the home. LPA observed wood burning fireplace within the home that is inoperable. Licensee stated there are no firearms or bodies of water on the premises. There is a pool within the community, which is fenced. Licensee understands that if there are any poisons in the home, all poisons must be locked with a key lock or combination lock.

LPA observed all required postings, a children's roster and fire drill log, the last fire drill was conducted 02/2023. LPAs reviewed records of children’s files and staff files, all which contained most of the required documentation. Licensee has current EMSA approved pediatric CPR/First Aid training, which expires 10/2024. Licensee has current Mandated Reporter Training, which expires 08/2024. Licensee understands both CPR and mandated reporter training's’ must be completed every two years.

LPA 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-andresources/safe-sleep as an additional resource. LPA also informed licensee [or 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.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/25/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: UTRILLA, DANIELLE
FACILITY NUMBER: 093624494
VISIT DATE: 08/25/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Based on today's inspection, no title 22 deficiencies are being cited.

During the exit interview, the licensee, Danielle Utrilla, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Exit interview conducted and report was reviewed with the licensee, Danielle Utrilla. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 08/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023
LIC809 (FAS) - (06/04)
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