293626487-12-18-2024-03-CC-MGAO-DC3VS3-20241218154053

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293626487
Report Date: 12/18/2024
Date Signed: 12/18/2024 03:41:05 PM

Document Has Been Signed on 12/18/2024 03:41 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	ABUNDIZ, ANGELICA		FACILITY NUMBER:	293626487
ADMINISTRATOR/ DIRECTOR:	ABUNDIZ, ANGELICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(775) 470-0519
CITY:	TRUCKEE	STATE: CA	ZIP CODE:	96161
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	12/18/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:15 PM
MET WITH:	Angelica Abundiz		TIME VISIT/ INSPECTION COMPLETED:	03:50 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	At 1:15 p.m. on 12/18/2024, Licensing Program Analyst (LPA) Matthew Gallo met with applicant Angelica Abundiz for the purpose of a change of location prelicensing inspection. Applicant has requested a Large Family Childcare Home License to serve up to 14 children, and was previously licensed at facility #313624265. The facility is a two story, 5 bedroom and 4 bathroom home. The downstairs portion of the home consists of a Daycare Entry Garage, Main Garage, Laundry Room, Master Bedroom/Bathroom, Kitchen, Living Room, and Dining Room. The upstairs portion of the home consists of the Daycare Area (which includes a Main Daycare Room, a Changing Room, Baby Room, and Daycare Bathroom), as well as a Spare Bedroom/Bathroom, Daughter's Bedroom/bathroom, Son's Bedroom, Upstairs Bathroom, and Office. Off limit areas will include: All Downstairs except Daycare Entry Garage, and all upstairs except Daycare Area. Applicant acknowledges that children must never enter these areas. The property is unfenced, and applicant understands that 100% supervision is required in all unfenced areas. Applicant intends to operate 7:30am-5:00pm, Monday-Friday, year-round. Applicant understands they must be present at the facility for 80% of operating hours per day. All individuals subject to criminal background review have obtained a criminal record clearance. Applicant was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. Report continues on 809-C

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ABUNDIZ, ANGELICA	FACILITY NUMBER: 293626487
	VISIT DATE: 12/18/2024

NARRATIVE

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LPA and applicant toured the entire facility and property. All toxic and hazardous items are inaccessible to children and applicant understands that any cabinet containing such items and is reachable by children must be made inaccessible. LPA observed a 2A10BC fire extinguisher along with functioning smoke and carbon monoxide detectors. Applicant stated that there are no firearms in the home. LPA observed a hot tub on the backyard deck that featured a locked hard cover that meets regulations. There are no fireplaces in the day care area. There is a stairway leading from the entry garage to the daycare area, which is made inaccessible by doors and licensee supervision.

Applicant provided proof of control of property in the form of a lease agreement. Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC9149). Without this consent, the applicant understands that, once licensed, they can operate with a maximum capacity of 12 children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 14 children. Applicant understands that until a liability insurance coverage in the amount of $300,000 is provided, the affidavit form LIC282 form will be used.

Current CPR and First Aid certification was verified and expires 5/2025, and AB 1207 Mandated Reporter Training was verified and expires 5/2025. Applicant understands that both CPR/First Aid certification and Mandated Reporter Training must be renewed every 2 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 applicant 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.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ABUNDIZ, ANGELICA	FACILITY NUMBER: 293626487
	VISIT DATE: 12/18/2024

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (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.

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 platform.
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.

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.

On 12/6/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

This facility evaluation report was reviewed and discussed with the applicant, Angelica Abundiz. LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. Applicant understands that upon the licensing of this new location, the license of their previous location will be voided and no further child care services can be provided there.

Report continues on 809-C

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ABUNDIZ, ANGELICA	FACILITY NUMBER: 293626487
	VISIT DATE: 12/18/2024

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	Prior to licensing, the following corrections are necessary: -The regional office must receive fire clearance for a Large Family Day Care Home license. Upon receipt of the fire clearance, the facility will be approved for a large license to serve a maximum capacity of 12 children (when there is an assistant present) with no more than four infants.

SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:	DATE: 12/18/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024

LIC809 (FAS) - (06/04)

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