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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621728
Report Date: 10/23/2024
Date Signed: 10/23/2024 11:22:36 AM

Document Has Been Signed on 10/23/2024 11:22 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:GUTIERREZ-JOHNSON, SONIAFACILITY NUMBER:
393621728
ADMINISTRATOR/
DIRECTOR:		SONIA GUTIERREZ-JOHNSONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 534-3578
CITY:ESCALONSTATE: CAZIP CODE:
95320
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
10/23/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Sonia Gutierrez-JohnsonTIME VISIT/
INSPECTION COMPLETED:
11:40 AM
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Licensing Program Analyst (LPA) Janie Davis met with Licensee, Sonia Gutierrez-Johnson for the purpose of an unannounced annual inspection. There were three children present at the time of inspection. Licensee's operating hours are Monday through Friday from 7:00 AM. to 5:00 PM. Also present was licensee's adult child.

All adults subject to criminal background review have obtained 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.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas: Kitchen, Family Room, Laundry Room, Entire Upstairs, Garage and Backyard Shed. LPA observed the required postings and a working phone. A 2A10BC fire extinguisher was observed and meets regulations. LPA observed a smoke and carbon monoxide detector, and verified they were both functional. LPA toured the kitchen area and verified knives were inaccessible to children in care. LPA observed play room to have age appropriate toys for children. LPA observed a restroom and verified that hazardous and toxic items were inaccessible to children in care. Licensee stated there are no weapons in the home. There are no bodies of water on the premises. Outdoor play space is in a fenced yard.


Report continues on 809-C.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE: DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2024
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: GUTIERREZ-JOHNSON, SONIA
FACILITY NUMBER: 393621728
VISIT DATE: 10/23/2024
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Three Children's files were reviewed. Emergency information and required immunization records were discussed. LPA observed a current roster and documentation that a fire drill's are conducted at least once every six months. Licensee's immunization records are available in the facility file. Current EMSA pediatric CPR and First Aid certification was verified and expires 09/2026. LPA discussed the Child Care Provider Mandated Reporter training and the requirement to renew the training every two years. Madated Reporter certification was verified and expires 07/2026. LPA advised licensee to utilize the website www.mandatedreporterca.com

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page 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 observed a copy of LIC 9227 Individual Sleeping Plan, for infants under 12 months in the infant files reviewed during today's inpsection.

This provider is not currently providing Incidental Medical Services (IMS) services to children in care. 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

Report Continues on 809-C
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: GUTIERREZ-JOHNSON, SONIA
FACILITY NUMBER: 393621728
VISIT DATE: 10/23/2024
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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/inspection-process

Exit interview conducted and report was reviewed with the licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
In the areas that were evaluated, no deficiencies were cited during today’s inspection.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC809 (FAS) - (06/04)
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