304310771-7-10-2019-06-CC-GCOY-BDXNCL-20190710102055

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 304310771
Report Date: 07/10/2019
Date Signed: 07/10/2019 10:21:02 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME:	ROCHE, LAURIE		FACILITY NUMBER:	304310771
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	07/10/2019
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Laurie Roche		TIME COMPLETED:	10:30 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	An annual inspection was conducted today by Licensing Program Analyst (LPA) Connolly. Present was licensee. No children were present. In February 2019 licensee applied for a large family child care home license. Fire clearance was issued March 2019. LPA is also here today due to the request for an increase in capacity. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. The floor plan was verified. Home is two story detached. There is a gate at the bottom of the staircase in addition to a gate at the entrance of the family room/kitchen area. The main day care areas are the family room, kitchen/eating area and downstairs bathroom. The upstairs and garage are off-limits areas. Licensee acknowledges that children are never to enter an off-limit area of the home. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medication, sharp knives and hazardous items that could pose a danger to children. The fireplace is screened thus inaccessible to children. The required fire extinguisher (2 A 10BC), carbon monoxide, and smoke detectors are in operable condition. Licensee's pediatric CPR and First Aid health cards are current until 2/27/2021. There are age appropriate toys and educational material for the preschool program provided by the licensee. The fenced backyard is designated for the outside play area for children in care. Outdoor children play equipment that appears age appropriate for ages served is located here. There is cushioning material underneath children climbing equipment There is a spa in the backyard. Spa has a cover. Licensee demonstrated today the spa cover supports the weight of an adult. Spa cover was locked requiring a key to open. continued on page two

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gesine Connolly	TELEPHONE: (714) 703-2822
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: ROCHE, LAURIE	FACILITY NUMBER: 304310771
	VISIT DATE: 07/10/2019

NARRATIVE

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LPA reviewed the need to practise disaster drills with children in care and to maintain a disaster drill log. Licensee's roster was complete as were children files. Proof of immunization against pertussis and measles for licensee and assistants was available for review. The mandated reporter certificates were verified by LPA. Licensee stated there are no firearms on the premises.

During today’s inspection LPA discussed incidental medical services with the licensee. Licensee said there are no incidental medical services being provided at this time. 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 licensing office within 30 days of providing IMS. The plan should describe the facility’s policies and procedures that ensure the proper safeguards are in place. 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

Reporting requirements were discussed as well as and criminal records clearances/exemption transfer requests. The licensee was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of this inspection. Large family child care home license will be issued.

SUPERVISOR'S NAME: Judy Hanson	TELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Gesine Connolly	TELEPHONE: (714) 703-2822
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2019

LIC809 (FAS) - (06/04)

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