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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393622672
Report Date: 08/03/2022
Date Signed: 08/03/2022 02:18:36 PM

Document Has Been Signed on 08/03/2022 02:18 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:DE TORRES GOMEZ, CELINAFACILITY NUMBER:
393622672
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
08/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:54 PM
MET WITH:Celina De Torres GomezTIME COMPLETED:
02:40 PM
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On Wednesday, August 3, 2022, Licensing Program Analyst (LPA) Elvira Sierra met with licensee Celina De Torres Gomez at the family childcare home for an annual inspection. In addition, LPA is visiting the facility for the purpose of increasing the capacity from 8 to 14 children. Five children were in care at the time of the visit. Licensee's adult son was also present during the inspection. Fire Safety Inspection Clearance was granted on 07/07/22 for a total capacity of 14 children. Facility hours of operation are M-F from 05:30 am to 05:30pm. All individuals subject to criminal background review have obtained a criminal record clearance.

LPA inspected all areas of the home and the following was observed; Off-limit areas include; Entire second floor, bedroom on first floor, garage, storage shed and fenced dog area in the backyard. Licensee understands that children may never enter these off-limit areas. The home is appropriately ventilated and suitable for children. All required posting were observed by the main entrance of the home. Age appropriate toys and reading material were observed, Fire extinguisher, carbon monoxide detector and smoke detector meet regulation. Hazardous cleaning compounds and medications are stored inaccessible to children. The backyard is fenced for supervision. LPA advised that fenced must be in good repair at all times. No bodies of water were observed. Firearm was observed to be locked and stored according to Title 22 regulations. A current CPR/First Aid was verified and expires on 11/07/22. Licensee's Mandated Reporter certificate was observed and expires on 06/02/24. LPA reviewed large family child care home capacity limitations with licensee and five children’s files were reviewed. Children's files were complete and contained all required documents. LPA discussed the requirements for a Licensee's assistant and explained that if no assistant present License capacity decrease to a small license. LPA observed a current roster and fire drills are conducted at least once every six months and are properly log.

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.


Report continues on subsequent page 809C-----
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/03/2022
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: DE TORRES GOMEZ, CELINA
FACILITY NUMBER: 393622672
VISIT DATE: 08/03/2022
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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. 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

LPA discussed the safe sleep regulations 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.

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.

As of today's date, facility is licensed to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in transitional Kindergarten or elementary school and 1 child at least age 6 with a maximum of 3 infants.

A Notice of site visit was given and posted. Notice of Site Visit must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Celina De Torres Gomez.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2022
LIC809 (FAS) - (06/04)
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