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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293624766
Report Date: 06/06/2023
Date Signed: 06/06/2023 05:02:52 PM

Document Has Been Signed on 06/06/2023 05:02 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
RIVER CITY (SACTO)CC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:CASTRO MIRABEL, NANCIFACILITY NUMBER:
293624766
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
06/06/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Nanci Castro MirabelTIME COMPLETED:
05:00 PM
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At 3:00 pm, Licensing Program Analyst (LPA) Matthew Gallo met with applicant Nanci Castro Mirabel for the purpose of a prelicensing inspection. Applicant has requested a small Family Childcare License to serve up to eight children.

The facility is one-building, two story home consisting of an entrance sunroom, living room, kitchen, dining area, three bedrooms, two bathrooms, a garage and front deck. Off limits areas will include all upstairs, which encompasses the three bedrooms and a bathroom, garage, and front deck. Hours of operation are 9:AM-5:00PM, Monday thru Friday. Applicant understands she must be present at the facility for 80% of operating hours. Applicant understands that their own children under 10 years old count toward the ratio.

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.

LPA and Applicant toured the entire facility. LPA observed functioning smoke and carbon monoxide detectors, and a 2A10-BC fire extinguisher. LPA reviewed the required postings with applicant. Cleaning materials, hazardous items, and medications are all stored inaccessible to children. There are no bodies of water on the property. Applicant understands that an inspection by the department must be made prior to making an off limits area on limits. Applicant stated that there are neither firearms nor poisons in the facility. Stairs are properly fenced. There is a heater in the living room with the facade of a fireplace, but does not reach temperatures requiring it to be barricaded.

Continued on LIC809-C
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE: DATE: 06/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2023
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
RIVER CITY (SACTO)CC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CASTRO MIRABEL, NANCI
FACILITY NUMBER: 293624766
VISIT DATE: 06/06/2023
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Applicant provided proof of control of property. Applicant understands that until a liability insurance coverage in the amount of $300,000 is provided, the affidavit form LIC282 form will be used. Applicant submitted proof of current CPR/First Aid, completion of Preventative Health and Safety Training, and Mandated Reporter certificate. Applicant understands the CPR and Mandated Reporter training must be renewed every two years.

LPA reviewed Safe Sleep regulations and provided the 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.

IMS was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417 and when any IMS is provided, an updated Plan of Operation that includes 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) 513-0301 (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.ht

This facility evaluation report was reviewed and discussed with the applicant. LPA discussed supervision, 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 childcare updates, forms, regulations and legislation pertaining to family childcare homes.

Effective today, June 6, 2023, the facility is approved for a Small Family Child Care Home license for a capacity of 6 children with no more than 3 infants, or 4 infants only, or up to 8 children with no more than 2 infants, 1 child in Transitional Kindergarten or above and 1 child at least age 6. Infants are children under the age of 2.

Exit interview conducted and report was reviewed with the applicant, Nanci Castro Mirabel.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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