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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393612165
Report Date: 11/21/2023
Date Signed: 11/21/2023 02:19:06 PM

Document Has Been Signed on 11/21/2023 02:19 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ESPINOZA, JAMIEFACILITY NUMBER:
393612165
ADMINISTRATOR:JAMIE ESPINOZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 599-9329
CITY:RIPONSTATE: CAZIP CODE:
95366
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
11/21/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Jamie EspinozaTIME COMPLETED:
02:45 PM
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On 11/21/2023 at 1:45 PM, Licensing Program Analyst (LPA) Tiffanie Diep met with Licensee Jamie Espinoza for the purpose of an unannounced Plan of Correction (POC) inspection. LPA observed three children present in the home with Licensee and their assistant.

All individuals subject to a criminal record review have obtained a criminal record clearance. Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of five days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

During an annual inspection conducted on 10/09/2023, Licensee was issued a Type B citation as required immunizations were not maintained for all personnel present. During today’s visit, LPA verified proof of the required immunizations for Licensee and their assistant. The deficiency is cleared effective today, November 21, 2023. A POC letter was provided to Licensee.

An exit interview was conducted and report was reviewed with the licensee, Jamie Espinoza. A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2023
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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