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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283002625
Report Date: 10/18/2021
Date Signed: 10/18/2021 12:34:49 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:MOROFSKY, LAURA FAMILY CHILD CARE HOMEFACILITY NUMBER:
283002625
ADMINISTRATOR:MOROFSKY, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 643-7882
CITY:AMERICAN CANYONSTATE: CAZIP CODE:
94503
CAPACITY:14CENSUS: 8DATE:
10/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:20 AM
MET WITH:Laura Morofsky, LicenseeTIME COMPLETED:
12:50 PM
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A Required- 1 year inspection was made to the facility by Licensing Program Analyst (LPA) Kevin O'Connell. A review of staff records on 10/18/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Currently there is one adult living in the home. During today’s inspection the home and grounds were toured.
The licensee and two assistants were supervising eight children and operating within the licensed capacity and ratio requirements.
No children were observed left in any parked vehicle. The facility’s operating hours are Monday - Friday; 07:00am - 05:30pm.
The off-limit areas were inaccessible by a door handle cover. The large child care room is located in the rear of the home and access is through a door on the left side of the home.
There is no garage. The fireplace is an electric (heater) with a glass face that does not open.
The back yard is fully fenced and used for outdoor play.
The Licensee states that there are no pools, spas, hot tubs or bodies of water and none were observed.
The home was clean and was at a comfortable indoor temperature. There were safe toys and equipment available for children. There is a working telephone in the home. The Licensee has current pediatric CPR and First Aid certifications which expires 06/23. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) were stored out of the reach of children.
Licensee states that there are no poisons but can be key lock them in the back yard shed. LPA observed a working smoke detector, carbon monoxide detector and charged fire extinguisher, rated at least 2A10BC, in the home. Licensee states that there are no firearms or dangerous weapons and none were observed.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2021
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,
, CA
FACILITY NAME: MOROFSKY, LAURA FAMILY CHILD CARE HOME
FACILITY NUMBER: 283002625
VISIT DATE: 10/18/2021
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Three staff files were reviewed at 11:50am for Mandated Reporter Certificates and immunizations, all were current. Eight children's records were reviewed at 11:40am; required emergency information cards were observed to be on file. No children need or are receiving Incidental Medical Services at this time.
The following information regarding ADA was provided: US Department of Justice 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, www.ada.gov/childqanda.htm. This report was reviewed and discussed with the licensee.
All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2