343617856-11-8-2024-03-CC-LPEZ-DATRX2-20241108122400

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343617856
Report Date: 11/08/2024
Date Signed: 11/08/2024 12:24:12 PM

Document Has Been Signed on 11/08/2024 12:24 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:	JAUREGUI, MARCELINA		FACILITY NUMBER:	343617856
ADMINISTRATOR/ DIRECTOR:	JAUREGUI, MARCELINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 689-7341
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95828
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	11/08/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Marcelina Jauregui		TIME VISIT/ INSPECTION COMPLETED:	12:45 PM

NARRATIVE

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Licensing Program Analyst (LPA) Loraine Perez met with, Licensee Marcelina Jauregui (Licensee), for an unannounced inspection. Present during today’s inspection were the Licensee, one assistant, and Licensee’s husband. A census of two infants, five preschool and two school age for a total of nine children were in care. All individuals subject to criminal background review have obtained a criminal record clearance. Facilities hours of operation are Monday through Friday 6:00 AM to 6:00 PM.

A health and safety inspection was conducted in the areas accessible to children. The home is a two story home with 4 bedrooms and 2.5 bathrooms and fenced backyard. Off limit areas include entire second floor, and garage. Licensee understands that children may never enter off-limits areas. LPA observed a working telephone, functioning smoke and carbon monoxide detector, and a 2A10BC fire extinguisher within the home. LPA observed the home was safe, orderly, and free of hazards. LPA observed a variety of age-appropriate toys. Licensee stated there are no firearms or bodies of water on the premises. Licensee has removed the jacuzzi and no longer has bodies of water on the premises. There is a trampoline on the back yard. Licensee was reminded to follow all manufacturer directions, weight requirements, and capacity requirements.

Licensee stated poisons are kept in the locked storage garage. 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, last conduced 10/30/2024. LPA reviewed records of children’s files and staff files, some required documentation was missing. Deficiency sited on LIC809D. Licensee has current EMSA-approved pediatric CPR/First Aid which expires on 03/2026 and Mandated Reporter certification which expires 12/2025. Licensee understands both CPR and Mandated Reporter training must be completed every two years.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: JAUREGUI, MARCELINA	FACILITY NUMBER: 343617856
	VISIT DATE: 11/08/2024

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA reviewed with Licensee the safe sleep regulations and 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 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.

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.

Two Title 22 deficiencies are being cited based on today's inspection and are recorded on LIC809D. Exit interview conducted and report was reviewed with Licensee Marcelina Jauregui. During the exit interview, Licensee Marceline Jauregui confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/08/2024 12:24 PM - It Cannot Be Edited

Created By: Loraine Perez On 11/08/2024 at 12:04 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: JAUREGUI, MARCELINA	FACILITY NUMBER: 343617856
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above Licensee did not have assistant's immunization record on file which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/06/2024
	Plan of Correction
1 2 3 4	Licensee stated she shall email a copy of the assistant's proof of immunization against pertussis and measles by plan of correction date 12/06/2024. loraine.perez@dss.ca.gov

Type B

Section Cited

CCR

102417(g)(7)

Operation of A Family Child Care Home

(7) An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above Licensee did not have a signed LIC627 on file for each child which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/06/2024
	Plan of Correction
1 2 3 4	Licensee stated she shall ask each family enrolled to complete missing document LIC627. Licensee stated she shall send by email the completed document LIC627 Consent to Medical Treatment to LPA L. Perez by the plan of correction date 12/06/2024. loraine.perez@dss.ca.gov

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Amanda Blesi

LICENSING EVALUATOR NAME:

Loraine Perez

LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2024

LIC809 (FAS) - (06/04)

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