393614905-12-26-2023-53-CC-TDIP-CYW2J8-20231226162555

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393614905
Report Date: 12/26/2023
Date Signed: 12/26/2023 04:26:11 PM

Document Has Been Signed on 12/26/2023 04:26 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:	LANDEROS, SYLVIA		FACILITY NUMBER:	393614905
ADMINISTRATOR:	SYLVIA LANDEROS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 833-2219
CITY:	TRACY	STATE: CA	ZIP CODE:	95304
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 2	DATE:	12/26/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Sylvia Landeros		TIME COMPLETED:	04:30 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 12/26/2023 at 1:00 PM, Licensing Program Analyst (LPA) Tiffanie Diep met with Licensee Sylvia Landeros for the purpose of an unannounced annual inspection, and Licensee guided LPA on a tour of the home. Licensee provided proof of control of property. LPA observed two children present in the home with Licensee and their assistant. Licensee's operating hours are Monday through Friday from 7:30 AM to 5:30 PM. LPA verified that annual fees are current. All individuals subject to a criminal record review have obtained a criminal record clearance. Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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. LPA reviewed both children's files, and LPA observed emergency information and required immunization records were on file. LPA observed a current roster. LPA discussed the requirement to conduct and document fire and disaster drills at least once every six months. LPA verified Licensee's immunization records were available in the facility file. Mandated Reporter Training certificate expired on 03/19/2020. LPA discussed the mandated reporter training requirement and Licensee was reminded to renew the course every two years. Current EMSA pediatric CPR and first aid certification was verified and expires on 01/28/2025. Continues on 809-C

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 12/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2023

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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LANDEROS, SYLVIA	FACILITY NUMBER: 393614905
	VISIT DATE: 12/26/2023

NARRATIVE

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Continued from 809 (Page 2)

A health and safety inspection of the home’s interior and exterior was conducted in all areas accessible to children. The off-limits areas in the home include the garage and both side yards. LPA observed the required postings and a working phone. LPA observed a 3A40BC fire extinguisher meets regulations and verified both smoke and carbon monoxide detectors were functional. LPA toured the kitchen area and verified knives were inaccessible to children in care. LPA observed two bathrooms and verified that toxic and hazardous items were inaccessible to children in care. LPA observed cleaners stored in bathroom cabinets out of reach and inaccessible to children in care. LPA observed the bedroom to the right of the laundry room with age-appropriate toys for children. Licensee stated there are no weapons in the home. LPA observed a fireplace that was barricaded by a metal screen. The outdoor play area was inspected and is surrounded by a concrete wall. LPA walked the perimeter of the outdoor play area during inspection and verified that the entire area is fenced in. The backyard has an in-ground pool area that is fenced according to Title 22 Regulations, and LPA observed the gate to self-close and self-latch.

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. LPA discussed the requirement to check and log infant napping every 15 minutes for infants under 24 months. LPA provided a copy of the Individual Sleeping Plan (LIC 9227) for infants under 12 months.

Incidental Medical Services (IMS) policy was discussed. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at https://www.ada.gov/resources/child-care-centers/.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:	DATE: 12/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2023

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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LANDEROS, SYLVIA	FACILITY NUMBER: 393614905
	VISIT DATE: 12/26/2023

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Continued from 809-C (Page 3)

To improve the quality and value of the new inspection process, a survey may be sent to the e-mail address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE Tool, please send e-mail inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at https://www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process. Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on LPA’s observations, interviews conducted, and records reviewed, a deficiency is being cited on the attached LIC 809-D. LPA Tiffanie Diep informed the licensee, Sylvia Landeros, that this report dated 12/26/2023 documents one Type B citation as there was a potential risk to the health, safety, or personal rights of children in care.

An exit interview was conducted and report was reviewed with the licensee, Sylvia Landeros. During the exit interview, Licensee confirmed that there are no registered sex offenders (RSO) living in the facility and LPA completed the RSO profile in the Field Automation System. 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: 12/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/26/2023 04:26 PM - It Cannot Be Edited

Created By: Tiffanie Diep On 12/26/2023 at 03:44 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: LANDEROS, SYLVIA	FACILITY NUMBER: 393614905
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/26/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(9)(A)

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: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations, interviews conducted, and records reviewed, the licensee did not comply with the section cited above as LPA observed the last fire and disaster drill was conducted on 04/25/2023 which poses a potential health, safety, or personal rights risk to persons in care.
	POC Due Date: 01/26/2024
	Plan of Correction
1 2 3 4	Licensee agreed to provide documentation of completed drill to LPA by 01/26/2023

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:

Chayntel Hunter

LICENSING EVALUATOR NAME:

Tiffanie Diep

LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2023

LIC809 (FAS) - (06/04)

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