343624997-6-28-2023-03-CC-EBAN-CT8NQW-20230628104038

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624997
Report Date: 06/28/2023
Date Signed: 06/28/2023 10:41:01 AM

Document Has Been Signed on 06/28/2023 10:41 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:	RAMIREZ, VIRGINIA		FACILITY NUMBER:	343624997
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	06/28/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Virginia Ramirez, Applicant		TIME COMPLETED:	10:55 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 June 28, 2023, Licensing Program Analyst (LPA) Eduardo Barragan met with Virginia Ramirez, Applicant for a pre-licensing inspection. LPA Barragan spoke with the applicant in Spanish due to that being her preferred language. Present at time of inspection was just the applicant. LPA toured the home inside and out, and reviewed forms for children's records. LPA Barragan provided the applicant with current forms that met current Tittle 22 Regulations. LPA explained about obtaining $300,000 liability insurance. Licensee understands that until a policy is obtained, she must use the affidavit. Applicant has certificates of completion for 16 hours of health and safety training including CPR and First Aid that is EMSA approved. The certificate expired 03/2025. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Virginia Ramirez, Applicant, were 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. The home consisted of 3 bedrooms, two bathroom a living room (used as a play area), a dinning room, a kitchen, a closet in the hallway, a garage and a backyard. Off-limit areas: are the three bedrooms, the master bathroom, the garage and the right side fenced are of the yard with the dogs. Applicant understands that children may never enter these off-limit areas. Applicants understands that they need to notify licensing for any modification inside and out of the home.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

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: RAMIREZ, VIRGINIA	FACILITY NUMBER: 343624997
	VISIT DATE: 06/28/2023

NARRATIVE

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There are two pets in the home. The Licensee understands that she has to keep supervision if children are ever near the dogs. There are no stairs in the home. Planned hours of operation are Monday through Friday, 6:30 AM to 6:00 PM and other hours as arranged. The Licensee will be transporting children.

LPA has provided the Applicants with the web site to enable access to all updated forms, requirements and changes. LPA reviewed the fire drill requirements. Applicant stated there are no weapons in the home. Fire extinguisher, carbon monoxide detector and smoke detectors met regulation. Hazardous cleaning compounds are inaccessible to children. Sharp utensils and Medications are inaccessible to children on the kitchen. There are no pools or spas in the home. Applicant understands that 100% supervision is required in any unfenced areas. Applicant will supervise day care children at all times.

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

LPA observed that applicant has completed the required mandated reporter training (AB 1207). Expiries 02/2025 website: www.mandatedreporterca.com.

LPA discussed and gave licensee the Effects of Lead Exposure brochure.

LPA discussed the safe sleep regulations with licensee Virginia Ramirez, Applicant, 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 Virginia Ramirez, Applicant, 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 provided the applicant with sleep safe regulations and form LIC 9227.

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

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

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: RAMIREZ, VIRGINIA	FACILITY NUMBER: 343624997
	VISIT DATE: 06/28/2023

NARRATIVE

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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 regards 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.

LPA reviewed with applicants the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. LPA Barragan gave applicants a forms packet at time of inspection.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

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.

The applicant will be licensed to serve up to either 8 children, two (2) of which must be at least 6 years of age and no more than two (2) may be infants; or 6 children, three (3) of which may be infants; or 4 infants only. Infants are children under the age of 2 years.

The Licensee is being granted her Licensee.

Exit Interview were conducted, and a copy of this report/appeal rights were provided to Virginia Ramirez, Applicant

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Eduardo Barragan
LICENSING EVALUATOR SIGNATURE:	DATE: 06/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023

LIC809 (FAS) - (06/04)

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