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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393617727
Report Date: 09/27/2023
Date Signed: 09/27/2023 11:56:06 AM

Document Has Been Signed on 09/27/2023 11:56 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MARQUEZ, TERESA / MARQUEZ, MARIOFACILITY NUMBER:
393617727
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 5CENSUS: 2DATE:
09/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Marquez Teresa and MarioTIME COMPLETED:
12:15 PM
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On 09/27/23, Licensing Program Analyst (LPA) Elvira Sierra met with the licensee, Teresa Marquez for the purpose of an unannounced annual inspection. All individuals subject to criminal background review have obtained a criminal record clearance verified by LPA accessing Guardian. Licensee owns the home. Home is a three bedrooms two bathroom house. Per Licensee hours of operation are M-F from 07:30am to 07:00pm. Present in the facility was Licensee caring for her two grandchildren. Licensee's adult daughter was also present during the inspection.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include; All bedrooms, front "sports room", craft room, fenced area in the backyard, and garage. Licensee stated that she would like to use the front room (sport room or living room) and the craft room( or dining room) as a part of the daycare area. After today's inspection off limits areas will be: All bedrooms, laundry room, bathroom # 2, entire backyard. Licensee was reminded that day care children may never enter these off-limit areas. Home is clean and appropriately ventilated. Age-appropriate toys and reading material were observed. Hazardous items were observed inaccessible to children. Medications and knives are inaccessible to children. Per Licensee there are no weapons in the home. LPA observed that the swimming pool in the backyard was removed. Facility maintains a working phone, a functioning carbon/monoxide detector and a 2A10BC fire extinguisher that meets Fire Marshall standards. LPA reminded Licensee that any changes to the home or any new construction must be reported to Licensing. Emergency drill are conducted at least every six months and are properly logged. First Aid Kit is fully stocked and accessible. Licensee stated she provide meals.

Licensee EMSA CPR and First Aid certification was verified (exp 09/25). Facility roster was reviewed and is complete and up to date. Licensee Mandated Reporter Training was verified and expires on 04/24/24. LPA received an updated LIC 279 (Application for A family Child Home License) and a LIC 279B (Current Children in your Home).
Report continues on subsequent page 809C—
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2023
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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: MARQUEZ, TERESA / MARQUEZ, MARIO
FACILITY NUMBER: 393617727
VISIT DATE: 09/27/2023
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All individuals subject to criminal background 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, 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.

Licensee acknowledges that a Plan for Providing IMS must be submitted to the Department if provided. 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. Licensee states she will not administer medication. 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.
Licensee was made aware of the (LIC9227) Individual Infant Sleeping Plan, for infants under 12 months and sleep logs for all infants in care under 24 months need to be maintained in children’s files. LPA discussed and provided an example of a sleep log and the safe sleep regulations with Licensee and provided 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 encouraged Licensee to visit the department website at WWW.CCLD.CA.GOV for information regarding childcare updates, forms, regulations and legislation pertaining to family childcare homes. -------Report continued on subsequent 809C...
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023
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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: MARQUEZ, TERESA / MARQUEZ, MARIO
FACILITY NUMBER: 393617727
VISIT DATE: 09/27/2023
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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.

Applicant was informed of the MyChildCarePlan.org website; 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.

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 platforms. 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.

An exit interview was conducted. This report and Appeal of Rights were reviewed and provided to Licensee, Teresa Marquez. Notice of Site Visit posted and should remain posted for 30 days.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023
LIC809 (FAS) - (06/04)
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