334846153-1-10-2022-09-CC-ECOL-CAJQDE-20220110110436

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334846153
Report Date: 01/10/2022
Date Signed: 01/10/2022 11:04:42 AM

Document Has Been Signed on 01/10/2022 11:04 AM - 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	CARRANZA FAMILY CHILD CARE		FACILITY NUMBER:	334846153
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	01/10/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Kassey Carranza		TIME COMPLETED:	11:20 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	On 01/10/2022 Licensing Program Analysts (LPA's) Eileen Corral and Destinee Hougue arrived at the facility to conduct a Pre-Licensing inspection. During this inspection Applicant and her 2 minor children were present in the home. Normal Hours of Operation are Monday – Friday 7AM – 6PM. During this inspection, LPA's reviewed COVID-19 guidance and resources with Applicant and advised Applicant to stay up to date with COVID-19 restrictions and guidance by checking the California Department of Public Health website, Local Health Department website and Community Care Licensing Division, along with the Provider Information Notices (PIN). The areas accessible to children in care are the living room which is the main room that will be used for care, the kitchen, the dining room and the restroom which is down the hallway to the left. The areas that are off limits to the children in care are all three bedrooms that are down the hallway. All bedrooms are made inaccessible by means of a door child safety knob. LPA's toured the inside and outside of the facility. The following was observed: · Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present in working order and were tested by the applicant during inspection · No guns or weapons present during the time of inspection, applicant understands all guns, weapons and ammunition must be key-locked separately and made inaccessible per Title 22 Regulations · Verification of control of property is on file · Facility Sketch and Emergency Disaster Plan are posted · Pediatric CPR and First Aid Certificate expire on 03/2023 · Mandated Reporter Certification was completed on 12/09/2021 Continue to Page 2.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Eileen Corral
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CARRANZA FAMILY CHILD CARE	FACILITY NUMBER: 334846153
	VISIT DATE: 01/10/2022

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
26
27
28
29
30
31
32

Page 2.
There are no bodies of water as of this date. Applicant understands all bodies of water including ponds, above ground pools and spas, in-ground pools and spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position when not in use.
· Clean, safe and age appropriate toys were observed outside, toxic plants were not observed at this time
· The Applicant was informed of their Reporting Requirements and was provided with the Regional Office Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
· The following information was provided to the Applicant: SIDS information and Shaken Baby Syndrome pamphlet – California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

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
· Criminal Record clearances are required prior to all adults living or working in a Family Child Care Home. Applicant was informed a civil penalty of $100.00 per day the person has been present, may be assessed. Resident and/or staff records reviewed on 01/03/2022 indicate that all adults who require caregiver background checks have received all required clearances or exemptions.
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at Associations_Disassociations862@dss.ca.gov
Continue to Page 3.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Eileen Corral
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: CARRANZA FAMILY CHILD CARE	FACILITY NUMBER: 334846153
	VISIT DATE: 01/10/2022

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
26
27
28
29
30
31
32

Page 3.
The following was discussed with the Applicant:
- Pre-Licensing Visit Packet provided (children’s/staff records & posting requirements included)
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a Mandated Reporter
- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Baby walkers, bouncy seats, saucers and other similar items are prohibited
- The applicant is advised to visit the U.S. Consumer Product Safety Commission webpage at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled
- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for 30 days
- A civil penalty of $100 per violation will be assessed for noncompliance of Posting Requirements
- Licensee was advised to subscribe at www.childcareadvocatesprogram.com to receive Department updates
- Licensee was informed the Duty Officer is available to answer questions from Monday – Friday, 8 AM– 5 PM at 951-782-4200

The Applicant has 2 dogs in the home, Applicant stated the dogs will be outside and they will not interact with the children in care. The dogs have their own space in the back yard which is gated, covered and locked.

The Applicant confirmed there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

Before licensure, the following needs to be corrected:
1. Toxins and medication must be made inaccessible by lock and key.

Applicant stated she will make her hallway cabinet lock and key. Once correction has been verified, the application for a Small Family Child Care Home will be submitted for approval. Applicant was advised that all corrections are due within 30 days or the application may be withdrawn. Exit interview was conducted, report was read and reviewed with the Applicant.
End of Report.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Eileen Corral
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3