073404309-12-16-2019-52-CC-JPLA-BJWQJA-20191216111224

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073404309
Report Date: 12/16/2019
Date Signed: 12/16/2019 11:12:30 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	GOETTING, RACHEL		FACILITY NUMBER:	073404309
ADMINISTRATOR:	GOETTING, RACHEL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 803-9619
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94583
CAPACITY:	14	CENSUS: 9	DATE:	12/16/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Rachel Goetting		TIME COMPLETED:	11:25 AM

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) Julia Placencia arrived for an unannounced Annual/Random Inspection, and met with Licensee Rachel Goetting. Present for this inspection were three infants, six preschool age children, and fingerprint cleared helpers Monica Armenta and Rosa Strong. Also residing in the home are the licensee's fingerprint cleared spouse, son, daughter and 12 year old granddaughter. The home was toured with the licensee to conduct a health and safety inspection. Hours of operation for day care are Monday through Friday, 7:00am to 5:30. ON LIMITS: Entire first floor, backyard. OFF LIMITS: Entire second floor, garage. Off limit areas are inaccessible by closed and/or locked doors and visual supervision. Licensee is aware she must contact Licensing, so that an inspection can be completed prior to changing an off limits area to on limits. The home is two story, which is neat and clean, with heating and ventilation for safety and comfort. Children's area is the gated lower level of home. The outdoor play area is fenced, has a gated chicken coop, and is free from defects and dangerous conditions. There were ample age appropriate toys, inside and out, that were observed to be safe and in good condition. The home has a gas burning stove in the living room. Per licensee, the living room is only used for napping infants in crib/pack-n-plays. Toxins, medicines, and hazardous items were inaccessible during today's inspection. Fire extinguisher, carbon monoxide and smoke detector meet State Fire Marshall standards. Per licensee, firearms are stored locked in the off limits second floor master bedroom and ammunition is stored separately. The licensee conducts and documents Fire/Disaster Drills at least twice a year, and the log indicates a drill was conducted 11/15/19. All required licensing documents are posted and visible for public review. ***Continued on LIC809C...

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2019

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: GOETTING, RACHEL	FACILITY NUMBER: 073404309
	VISIT DATE: 12/16/2019

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At 10:10am, children's files were reviewed and found to be complete. The facility roster was reviewed, and a copy obtained. The licensee is in ratio today. The licensee's Pediatric CPR/First Aid certificate is current and expires 7/28/20. Licensee and helpers have proof of the required immunizations, and mandated reporter training has been completed. Safe Sleep practices were discussed. Licensee was reminded that children are never to be left in a parked vehicle.

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 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)/ (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.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident.

Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to also email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list.

There were no deficiencies cited during today's inspection. This report shall remain on file for 3 years. A Notice of Site visit was posted at time of inspection and must remain posted for 30 days.

Exit interview conducted with Rachel Goetting. Copy of report and appeal rights provided.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2019

LIC809 (FAS) - (06/04)

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