343623145-7-25-2023-03-CC-EBAN-CU3RW9-20230725132243

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623145
Report Date: 07/25/2023
Date Signed: 07/25/2023 01:22:50 PM

Document Has Been Signed on 07/25/2023 01:22 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:	CRUZ, GRISELDA		FACILITY NUMBER:	343623145
ADMINISTRATOR:	GRISELDA CRUZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 997-3283
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95824
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	07/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Griselda Cruz, Licensee		TIME COMPLETED:	01:45 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 July 25, 2023, an unannounced annual/random inspection was made today by LPA Barragan. Present at time of inspection were licensee, 5 day care children. LPA Barragan spoke with Griselda Cruz, Licensee. LPA tour of the home was conducted the inspection, inside and outside, as shown on the facility sketch is conducted. Licensee states there are no weapons or firearms in the home. There was a above ground pool in the home. The pool was not fenced as directed by title 22 regulations nor had the correct pool cover as directed by title 22 regulations. One civil Penalty is being administered due to this deficiency. LPA observed poisons, cleaning compound's, medications and other hazardous items are inaccessible to children. There was a no fireplace in the home. Fire extinguisher, Carbon Monoxide Detector and Smoke Detector meets regulations. Currently, Licensee does not have any pets in the home. There are no stairs in the home. Toys and play equipment that were observed appeared to be safe. There is a working telephone. Adequate supervision is being provided during this inspection. Children are supervised when outside in any unfenced play area. There was 1 infant under 12 months old present. The one story home has a unfenced front yard, 3 bedrooms, 1 bathroom, garage, kitchen, living room, dining room, laundry room, and fenced backyard with a shed. Off-limits areas in the home to be: Bedroom #2, garage, laundry room, and shed. Off-limits areas will remain inaccessible to children by closed doors and/or supervision. Licensee acknowledges that children may never enter these off-limit areas. Licensee was notified that prior to use of any off limits area, the department must be notified. Pediatric CPR/FA is current with expiration date of 12/2023. A child roster is maintained. Fire and disaster drills have been conducted every six months and documented. (Last fire drill was completed 03/13/2023.) Five child's records were reviewed during this inspection.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

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: CRUZ, GRISELDA	FACILITY NUMBER: 343623145
	VISIT DATE: 07/25/2023

NARRATIVE

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LPA's discussed AB 633, Parent Notification Requirements, and the posting of licensing inspection notices and reports. Hours of operation are 7:30 AM to 5;30 PM; Monday thru Friday and other hours as arranged. Licensee states she does transport children.

Licensee Griselda Cruz, 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.

LPA discussed the safe sleep regulations with licensee Griselda Cruz, Licensee, 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 licensee Griselda Cruz, 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.

LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.

LPA observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com .Mandated is current until 11/2023.

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 .No children currently on medication.

CONTINUED...

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023

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: CRUZ, GRISELDA	FACILITY NUMBER: 343623145
	VISIT DATE: 07/25/2023

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LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regard to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

To receive important licensed- related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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/process.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA Barragan informed Griselda Cruz, Licensee, that this report dated 07/25/2023 document's 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk's to the health, safety, or personal rights of children in care.

Also, LPA Barragan informed the licensee Griselda Cruz, Licensee, to provide a copy of this licensing report dated 07/25/23 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted. A copy of this report and appeal rights was reviewed/provided with the Griselda Cruz, Licensee.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/25/2023 01:22 PM - It Cannot Be Edited

Created By: Eduardo Barragan On 07/25/2023 at 12:54 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: CRUZ, GRISELDA	FACILITY NUMBER: 343623145
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/25/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102417(g)(5)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above due to having a above-ground pool that was not fenced nor had the appropriate covering. Which poses an immediate health, and safety risk to persons in care.
	POC Due Date: 07/26/2023
	Plan of Correction
1 2 3 4	The Licensee stated that she will remove the pool. LPA Barragan will be out here within 10-Days to ensure that the pool is removed.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Eduardo Barragan

LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023

LIC809 (FAS) - (06/04)

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