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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623609
Report Date: 07/19/2022
Date Signed: 07/19/2022 03:13:38 PM

Document Has Been Signed on 07/19/2022 03:13 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:GARCIA, NATALIEFACILITY NUMBER:
343623609
ADMINISTRATOR:GARCIA, NATALIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 203-1949
CITY:SACRAMENTOSTATE: CAZIP CODE:
95838
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
07/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Garcia, NatalieTIME COMPLETED:
03:30 PM
NARRATIVE
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On July 19, 2022 at 12:45 PM, Licensing Program Analyst (LPA) Alize Tillery met with licensee Natalie Garcia for the purpose of an annual required 1 year inspection. Upon arrival, LPA observed 13 children, supervised by Licensee and her spouse. The facility’s days and hours of operation would be Monday - Friday from 7:00 AM to 5:00 PM. All individuals subject to criminal background review have obtained a criminal record clearance.

A health and safety evaluation was conducted in all areas accessible to children. Off-limits areas will include: entire second floor and the garage.

LPA observed a 2A10BC fire extinguisher, first aid kit and functioning smoke and carbon monoxide detectors. Per licensee, there are no weapons in the home. No children were observed in parked cars nor infants in a car seat. Toxic and hazardous items are inaccessible to children, and safe toys were observed.

Upon arrival, LPA observed three, 3 to 4 year old children, napping in pack n plays. LPA informed Licensee that children who are able to climb out of a crib or pack n play, should not be sleeping in a crib or pack n play. Licensee stated that she has purchased more sleeping mats for the older children. LPA observed, one, 1 year old infant, napping in a pack n play with a blanket, LPA reminded Licensee of the safe sleep regulations. Licensee immediately removed the blanket.

LPA reviewed 13 children files, all children that were present - all files were observed to be complete. Licensee is maintaining the children’s roster. Licensee has a record of conducting fire drills at least every six months, last fire drill was conducted on 6/30/2022. LPA observed licensee’s CPR and First Aid card which expires 08/02/2023. Staff files were reviewed and were observed to be complete. LPA discussed COVID19 guidelines.

LPA discussed the requirement of renewing mandated reporter training every 2 years. Licensee’s mandated reporter training is current and expires on 3/29/2024.

Continued on LIC809C…
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2022
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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Document Has Been Signed on 07/19/2022 03:13 PM - It Cannot Be Edited


Created By: Alize Tillery On 07/19/2022 at 02:47 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: GARCIA, NATALIE
FACILITY NUMBER: 343623609

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that LPA observed a 1 yr old infant sleeping in a pack n play with a blanket, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/20/2022
Plan of Correction
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LPA reviewed the safe sleep regulations with Licensee. Licensee will submit a correspondence to LPA Tillery, stating that she is aware that cribs/pack n plays are to be free of loose articles and objects.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Seychelle De Luca
LICENSING EVALUATOR NAME:Alize Tillery
LICENSING EVALUATOR SIGNATURE:
DATE: 07/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/19/2022


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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: GARCIA, NATALIE
FACILITY NUMBER: 343623609
VISIT DATE: 07/19/2022
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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 submitting 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

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.

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 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 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.

A deficiency is cited on the following LIC809D. Appeal Rights were provided.

A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and report was reviewed with the Licensee, Natalie Garcia.


SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022
LIC809 (FAS) - (06/04)
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