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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619010
Report Date: 01/30/2024
Date Signed: 01/30/2024 11:53:15 AM

Document Has Been Signed on 01/30/2024 11:53 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:JONES, TERUKOFACILITY NUMBER:
343619010
ADMINISTRATOR:JONES, TERUKOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 646-4094
CITY:SACRAMENTOSTATE: CAZIP CODE:
95838
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
01/30/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Jones, TerukoTIME COMPLETED:
12:30 PM
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At 9:00 a.m. on 1/30/2024, Licensing Program Analyst (LPA) Pa Dao Vang met with Licensee, Teruko Jones, for the purpose of an unannounced, required - 3 year inspection. There were 9 day-care children were present during inspection. Licensee stated there are 16 children currently enrolled. Facility hours of operation are from 6:00 a.m. - 6:00 p.m., Monday thru Friday. Off limits areas include bedrooms #2, #3, #4, laundry room, and garage.

All individuals subject to criminal background review have obtained a criminal record clearance. Licensee 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. LPA observed the required postings, a working phone, 2A-10-BC fire extinguisher, and functioning combination smoke and carbon monoxide detector. Licensee stated that there are no weapons nor poisons in the home. Toxic and hazardous items were appropriately stored, inaccessible to children.

LPA reviewed staff files. Licensee is CPR and First Aid Certificate expires on 10/2025. LPA observed Mandated reporter training certificate expiring 2/3/2024. LPA reviewed children's files with all the required documents. LPA informed Licensee of location change for regional office and provided updated parents’ rights forms and postings with current address. LPA provided a copy of the Notification of Parent's Rights to post in the facility.

Continue report on LIC809-C...
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Dao Vang
LICENSING EVALUATOR SIGNATURE: DATE: 01/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/30/2024
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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