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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293624312
Report Date: 05/16/2022
Date Signed: 05/16/2022 11:26:48 AM

Document Has Been Signed on 05/16/2022 11:26 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:AGUILAR, JUANFACILITY NUMBER:
293624312
ADMINISTRATOR:AGUILAR, JUANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 414-6786
CITY:TRUCKEESTATE: CAZIP CODE:
96161
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/16/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Juan AguilarTIME COMPLETED:
11:45 AM
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On Monday, May 16, 2022, at approximately 10:30 AM, Licensing Program Analyst (LPA) Alize Tillery met with Applicant Juan Aguilar for the purpose of an announced pre-licensing inspection. During today’s visit, applicant was present. Applicant has a criminal record clearance. Applicant plans to operate Monday – Saturday from 8:00 AM to 5:00 PM. Applicant will not offer transportation services.

A health and safety inspection was conducted inside and outside the home. The home includes 3 bedrooms, 3 bathrooms, living room, kitchen, play area, laundry room, garage, gazebo and a fenced front yard and back yard. Off-limit areas will include: the laundry room, garage and bathroom #2 (located in bedroom #2). Applicant understands that children may never enter these off-limit areas.



There is a fireplace in the home that is appropriately gated. Toxic and hazardous items are inaccessible to children and out of children’s reach. Sharp knives are stored in the kitchen area, out of children’s reach. Children’s medications will be stored in a higher cabinet, out of children’s reach. A functioning smoke detector, carbon monoxide detector and a full 2A10BC fire extinguisher was observed in the home. LPA observed all required licensing postings. COVID19 guidelines were discussed.

Applicant Juan Aguilar completed the required Preventative Health and Safety course and the Lead Poisoning Prevention, and EMSA certified CPR and First Aid training in 04/2022. Applicants CPR certificate expires in 4/2024. Applicant completed the Mandated Reporter Training; Applicant’s certificate expires 4/29/2024. Applicant is aware that the CPR and Mandated Reporter trainings are to be renewed every two years. There is a weapon in the home that is appropriated locked and stored away. There are no bodies of water on the premises. Applicants were encouraged to maintain supervision at all times. Type A/B citations and Immediate Civil Penalty regulation deficiencies were reviewed.

Report continues on LIC809-C.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2022
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: AGUILAR, JUAN
FACILITY NUMBER: 293624312
VISIT DATE: 05/16/2022
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Applicant 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.

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 submitting 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 with Applicant 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 Director 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.


An exit interview was conducted with Applicant and Covid-19 protocols were discussed. LIC311D, records, postings, and reporting requirements were discussed. LPA discussed personal rights, criminal record clearances, ratios and capacity, and maintaining buildings and grounds. Applicant was encouraged to visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to family child care homes.

As of today May 16, 2022 facility is approved for a Large Family Child Care Home license. The facility is licensed to serve a MAX. CAP (WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2022
LIC809 (FAS) - (06/04)
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