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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 344500761
Report Date: 04/21/2023
Date Signed: 04/21/2023 12:47:39 PM

Document Has Been Signed on 04/21/2023 12:47 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:GARCIA, ERENDIDAFACILITY NUMBER:
344500761
ADMINISTRATOR:GARCIA. ERENDIDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 794-9642
CITY:ELK GROVESTATE: CAZIP CODE:
95624
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
04/21/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Erendida GarciaTIME COMPLETED:
01:15 PM
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On 04/21/2023, Licensing Program Analyst Katy Maestas (LPA1) and Licensing Program Analyst Jennie Tedlos (LPA2) met with Applicant Erendida Garcia (A1) for the purpose of a pre-licensing inspection. LPAs disclosed the purpose of the inspection and was granted entrance into the Family Childcare Home (FCCH). LPA1 provided the Entrance Checklist to A1. Also present in the FCCH was A1's mother. All individuals subject to criminal background review have obtained a criminal record clearance verified by LPA1 accessing Guardian. A1’s tentative hours of care are Monday through Friday, from 7:00 AM until 6:00 PM. A1 does not intend on providing overnight or weekend care. A fire inspection was granted on 03/09/2023. A health and safety inspection was conducted inside and outside of the FCCH. A1 accompanied LPAs for the entirety of the tour. The FCCH is a two-story house; the 1st floor contains a kitchen, dining room, family room, living room (used as a play room for day care kids), bathroom, laundry room, bedroom #1 and access to the garage. The 2nd floor contains the master bedroom and bathroom, bedroom #2, bedroom #3, and a bathroom. LPAs verified that toxic and hazardous items were inaccessible to children in care. LPAs observed a baby-gate barricading the stairway to make the stairs inaccessible to children in care. LPAs observed a fireplace which is barricaded by a glass door; however, A1 stated that the fireplace is not used during operational hours. The outdoor play area was toured which includes the backyard. LPA1 verified that the entirety of the backyard is fenced-in and walked the perimeter to ensure the safety of the fence. LPAs observed a water fountain in the backyard which is barricaded by a baby-gate. Additionally, LPAs did not observe any water in the fountain, and A1 acknowledged that supervision is critical near any water feature. LPAs observed a hot tub located in the backyard. LPA1 checked the locking straps on 2 sides of the hot tub and attempted to lift or open the lid and was unable to do so. LPA1 recommended that the stairs be removed from the hot tub to make the hot tub less accessible to children. A1 stated that she has 1 dog who resides in the FCCH. The OFF-limits areas of the FCCH are the family room, kitchen, dining room, laundry room, bedroom #1, garage, and entire 2nd floor of the FCCH, and the side yard. A1 understands that OFF-limits areas must remain inaccessible to children in care.
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SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE: DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2023
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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: GARCIA, ERENDIDA
FACILITY NUMBER: 344500761
VISIT DATE: 04/21/2023
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A functioning smoke detector and carbon monoxide detector was observed in the kitchen and tested. LPA1 observed cleaners stored in the OFF-limits garage on shelves that are high up and inaccessible to children in care. A 2A10BC fire extinguisher was observed in the living room and appeared to be in the green zone, and a first aid kit was also observed in the living room. A1 stated there are no firearms in the home.
LPA1 discussed Mandated Reporter Training with A1. Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their Mandated Reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at:http://www.mandatedreporterca.com. The training is currently provided in English and Spanish. A1 has a current Mandated Reporter Training Certificate which will expire on 03/27/2025. Current Pediatric CPR and First Aid training was verified for A1 and expires on 02/05/2024. Completion of Preventative Health and Safety training, including nutrition and lead exposure, was verified before the inspection. Proof of required immunizations for A1 was also verified before the inspection.

LPA1 discussed the Safe Sleep Regulations with A1 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. LPA1 also informed A1 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. LPA1 discussed the requirement to check and log infant napping every 15 minutes for infants under 24 months old. LPA1 provided a copy of the LIC 9227/Individual Sleeping Plan to be completed for infants under 12 months old.

APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS: Incidental Medical Services (IMS) policy was discussed with A1. 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: http://www.ada.gov/childqanda.htm

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SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2023
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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: GARCIA, ERENDIDA
FACILITY NUMBER: 344500761
VISIT DATE: 04/21/2023
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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. To receive important licensed related information, 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.

A1 was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

A1 understands that licenses are not transferable, and once licensed, Licensee must live in the home and be present for 80% of the operating hours. A1 understands that if an unusual incident occurs; Licensing is to be notified via phone call, e-mail or fax within 24 hours and the LIC 624/ Unusual Incident Report shall be submitted within 7 days to remain in compliance. A1 understands that if any structural changes are made to the FCCH; Licensing must be notified PRIOR to construction.



A1 understands that if she wants to make any OFF-limits area an ON-limits area, she must notify Licensing and LPA must do an inspection BEFORE children are allowed in said area. A1 understands that children’s and staff’s records are to be maintained according to Title 22 regulations and be accessible to Licensing for up to 3 years. LPA reviewed with Licensee 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. A1 understands that fire drills must be conducted and documented once every six months.

As of today, 04/21/2023, A1 is approved for a Large Family Child Care Home licensed to serve 12 children (when there is an assistant present) with no more than 4 infants OR a capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or above and 1 child at least aged 6 years with a maximum of 3 infants. Without an assistant, the ratios revert to those for a Small Family Child Care Home.

An exit interview was conducted and the report was reviewed with A1. LPA1 provided A1 with Licensee Appeal Rights. A Notice of Site visit was posted by LPA1 and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2023
LIC809 (FAS) - (06/04)
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