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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623618
Report Date: 12/03/2024
Date Signed: 12/03/2024 12:19:13 PM

Document Has Been Signed on 12/03/2024 12:19 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:MUNOZ, GISELA & SANDROFACILITY NUMBER:
313623618
ADMINISTRATOR/
DIRECTOR:		MUNOZ, GISELA & SANDROFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 223-2415
CITY:ROSVILLESTATE: CAZIP CODE:
95747
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
12/03/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Gisela MunozTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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Licensing Program Analyst (LPA) Erwina Pascual-Golamco met with Licensee, Gisela Munoz, to conducted a Plan Of Correction inspection and amended report for LIC9099 and LIC809 dated 11/26/24. Purpose of inspection was explained. There were 4 Type A deficiencies cited on 11/26/24.

CCR 102417(g)(5)(A) - 102417(g)The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: (5)All licensees shall ensure the inaccessibility of pools....hot tubs, spas,...through a pool cover or by surrounding the pool with a fence.(A) …. Pool covers shall be....locked while the pool is not in use.

on 12/03/24, LPA observed the spa/hot tub is locked and secured in place so that no part of it can be lifted more than 4" off of the spa, has a locking mechanism that has a key or tool to unlock or remove. The ladder was also made inaccessible to children.

CCR 102417(g)(3) -102417(g)The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: (3)Where children less than five years old are in care, stairs shall be fenced or barricaded.

LPA observed licensee installed a safety gate that barricades the stairs.

CCR102425(h) -102425(h)Car seats shall only be used for transportation purposes and shall not be used for sleeping.

LPA observed licensee in compliance with regulation and Licensee stated they only use car seats for its intended purpose.

continued on LIC809-C...

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: MUNOZ, GISELA & SANDRO
FACILITY NUMBER: 313623618
VISIT DATE: 12/03/2024
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CCR102425(a)(3)

102425 Infant Safe Sleep(a)There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3)Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

LPA observed both play yards are covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

As of today, 12/03/24, LPA observed that Licensee has corrected all Type A deficiencies. No deficiencies cited in today's inspection, exit interview was conducted, and Notice of Site visit was provided and shall be posted where visible to parents for 30 days

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Erwina Pascual-Golamco
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
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