093606132-5-10-2019-03-CC-ESIA-BC2RUG-20190510131954

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 093606132
Report Date: 05/10/2019
Date Signed: 05/10/2019 01:20:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	SPIETH, CHERYL		FACILITY NUMBER:	093606132
ADMINISTRATOR:	SPIETH, CHERYL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 642-1685
CITY:	DIAMOND SPRINGS	STATE: CA	ZIP CODE:	95619
CAPACITY:	14	CENSUS: 5	DATE:	05/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Cheryl Spieth		TIME COMPLETED:	01:40 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)Elvira Sierra met with licensee, Cheryl Spieth, for an unannounced Annual/Random inspection. Purpose of the inspection was explained. Upon arrival present in the facility was Licensee caring for 5 children (2 Infants, 3 Preschool). One infant was picked up a few minutes later. Facility hours of operation are: M-F from 07:00 AM to 06:00 PM. Capacity and ratio requirements were met on this day. All adults living and working in the home have criminal record clearances on file with Licensing Office. Licensee stated that her son(23 y/o) is not longer living in the facility. Licensee was advised that if her son returns to live in the home criminal record clearance must be file with Licensing Office. A health and safety inspection was conducted in all areas accessible to children and the following was observed; Off-limits areas are: Master bedroom, master bathroom (inside master bedroom), and garage. Licensee understand that children may never enter these off-limits areas. Home is clean and appropriately ventilated. LPA observed the required postings, a working telephone, 2A10BC fire extinguisher and functioning smoke and carbon monoxide detectors. A variety of toys and learning equipment available to the children. Licensee stated there are no weapons in the home. There are no bodies of water on the premises. Medications, toxic and hazardous items are inaccessible to children. Magnetic locks are in use on some kitchen cabinets, bathroom cabinets and drawers. The applicant understands that she must ensure the magnetic locks are not broken. Home has an electric fireplace that is covered by a ceramic heat-resistant glass. Outdoor play area is fenced for supervision and is free from defects or dangerous conditions. 3 children’s files were reviewed and Family Child Care Home Notification of Parents’ Rights and required immunization records were on file. LPA observed a current children’s roster. Fire drills are conducted at least once every six months and are properly log. The licensee and staff immunization records for measles (MMR), pertussis (Tdap), and the flu are available in the facility file and CPR and First Aid certification was verified and Licensee CPR expires 03/10/20. AB 1207 Mandated Reporter Training was verified and expires 02/20. Report continued on page 2..

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: SPIETH, CHERYL	FACILITY NUMBER: 093606132
	VISIT DATE: 05/10/2019

NARRATIVE

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LPA advised Licensee that she should be present in the home and shall ensure that children in care are always supervised. When temporarily absent from the home, the licensee should arrange for a substitute adult to care for and supervise children in her absence. Licensee understand that the Department has inspection authority and may enter and inspect the facility at an anytime, with or without notice. Licensee was advised that all individuals subject to criminal record review shall obtain a criminal record exemption prior to working, residing or volunteering in a licensed home. \
This provider is currently not providing IMS services to children in care. 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.
LPA advised the licensee on Safe Sleep Practices and SIDS; the licensee stated they are understood and practiced. She stated she uses cribs for sleeping infants and understand infants cannot sleep in car seats, swings or other items not intended for sleeping.
LPA also discussed the Smoking Probation Regulation (AB 1819-Smoking Prohibition), and the Nutritious Beverage Act.
Lead Poisoning Facts Information Flyer was provided and Licensee was advised that beginning January 1, 2019 a new law (AB 2370) requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families.
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.

LPA verified the annual fees are current. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so the licensee can request to be added to the distribution list to receive Quarterly Updates.

This facility evaluation report was reviewed and discussed with the licensee. A Notice of Site Visit was provided and should remain posted for 30 days for parental review A copy of this report will remain on file for a period of three years for public review upon request. The licensee's signature on this form acknowledges receipt of this form. In the areas that were evaluated, no deficiencies were observed today under Title 22 Division 12 of the Ca. Code of Regulations.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019

LIC809 (FAS) - (06/04)

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