053619656-3-20-2024-53-CC-ETJA-D3JSWZ-20240320141509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 053619656
Report Date: 03/20/2024
Date Signed: 03/20/2024 02:15:15 PM

Document Has Been Signed on 03/20/2024 02:15 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	ROE, LINDA		FACILITY NUMBER:	053619656
ADMINISTRATOR:	LINDA ROE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 754-9011
CITY:	SAN ANDREAS	STATE: CA	ZIP CODE:	95249
CAPACITY:	14	CENSUS: 14	DATE:	03/20/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:32 PM
MET WITH:	Linda Roe		TIME COMPLETED:	02:30 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	Licensing Program Analyst (LPA) Tjhia and Licensing Program Manager (LPM) Engelman conducted an unannounced inspection and met with Licensee, Linda Roe. LPA observed 14 children supervised by Licensee and a staff. Criminal record clearances have been verified. Licensee operation hours are Monday- Friday: 7 AM - 6 PM. Licensee 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. LPA and Licensee toured the facility during the inspection. During today inspections, Licensee requested the outdoor to be the on limit area. LPA tour area and observe no hazardous items accessible for the children. On 03/20/2024 LPA will approve this area to be on limit area. Off limit areas are the top floor, guest, mech, sun room, and garage. Off limit areas are being made inaccessible by closed locked doors, baby gates and supervision. Licensee stated there are no weapons in the home. There are no bodies of water on the premises. LPA conducted record reviews during the inspection. Six children's files, Licensee's and staff's files were reviewed. LPA discussed mandated reporter training with the Licensee Licensee was reminded that Mandated Reporter Training is to be completed every two years. Mandated reporter training can be accessed at www.mandatedreporterca.com. CPR/First Aid certification was reviewed for Licensee. Certification expiration date is 11/2025. LPA observed fire drills were conducted at least once every six months and documented. Report Continue on 809-C

SUPERVISOR'S NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Erwin Tjhia	TELEPHONE: 916-698-8127
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024

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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ROE, LINDA	FACILITY NUMBER: 053619656
	VISIT DATE: 03/20/2024

NARRATIVE

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LPA observed that there were no hazardous items accessible to children. LPA observed that cleaning materials were inaccessible. Fire extinguisher, smoke detector, and carbon monoxide detector meet regulation. Toys appear to be safe.

This facility does not provides Incidental Medical Services – IMS. For IMS information see PIN 22-02-CCP. 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 are available at: https://www.ada.gov/resources/child-care-centers/.

LPA discussed the safe sleep regulations with licensee 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. In addition, LPA discussed the infant sleep regulations with licensee. LPA observed 15min infant napping logs for infants 24 months and under. LPA discuss the LIC 9227 Individual Sleeping Plan, for infants under 12 months, for licensee during today's inspection.

Licensee 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 this date, 03/19/2024, 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.

Report Continue on 809-C

SUPERVISOR'S NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Erwin Tjhia	TELEPHONE: 916-698-8127
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024

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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ROE, LINDA	FACILITY NUMBER: 053619656
	VISIT DATE: 03/20/2024

NARRATIVE

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Exit interview was conducted and report was reviewed with Licensee, Linda Roe. A notice of site visit was provided and posted by LPA and must remain posted for 30 days.

No Title 22 deficiencies observed in the areas evaluated during the inspection.

SUPERVISOR'S NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Erwin Tjhia	TELEPHONE: 916-698-8127
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024

LIC809 (FAS) - (06/04)

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