313608660-10-10-2019-03-CC-JMCN-BGTP3Z-20191010105823

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313608660
Report Date: 10/10/2019
Date Signed: 10/10/2019 10:58:33 AM

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:	MIAN, NUZHAT		FACILITY NUMBER:	313608660
ADMINISTRATOR:	MIAN, NUZHAT		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 622-1073
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95765
CAPACITY:	14	CENSUS: 6	DATE:	10/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Nuzhat Mian		TIME COMPLETED:	11:10 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) Jeremey McClain met with licensee Nuzhat Mian for an unannounced annual/random inspection. LPA observed a census of six children, which included two infants and four preschoolers. Licensee stated there aren’t new residents in the home. All adult residents currently have criminal record clearances. LPA toured areas of the home accessible to the children. The off-limit are: the upstairs and the garage. LPA observed current CPR/First Aid certificate which expires 10/27/2020. LPA observed the following posted: a license, a Parents' Rights Poster and an Emergency Disaster Plan. LPA reviewed children's records for completeness, as well as the client roster. Licensee provided proof of immunizations for MMR, Pertussis, and influenza. LPA discussed the Provider Information notice 19-08-CCP which discusses new immunization requirements from the Department of Public Health. LPA provided licensee with and updated CPDH 286 for recording children’s immunizations. LPA observed that hazardous items (detergents, cleaning compounds, medication, sharp utensils, and other items that could pose a danger to children in care) are properly stored out of children's reach. LPA observed a fire place that was properly screened, and stairs were properly barricaded. There is a working telephone in the home. Licensee stated there were no weapons in the home. Licensee’s fire extinguisher, carbon monoxide and smoke detector meet regulation. LPA observed fire drills documented on a calendar, indicating that the licensee is conducting disaster drills at least once every 6 months. Toys appear to be safe and in working order. The backyard is fenced. LPA did not observe any bodies of water on the premises. REPORT CONTINUED ON THE FOLLOWING PAGE.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

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: MIAN, NUZHAT	FACILITY NUMBER: 313608660
	VISIT DATE: 10/10/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed and the licensee is not currently providing IMS. 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

AB1207 Mandated Reporter training was observed to be current through 10/29/2020. LPA provided Licensee with website: http://childcare.mandatedreporterca.com/ and reminded the licensee that the training must be completed once every two years.

LPA discussed recent changes in licensing requirements, Safe Sleep Regulations Concepts and provided licensee with Provider Information Notice. LPA also provided licensee with CDSS’ AB 2370 brochure regarding the effects of lead exposure. LPA provided the licensee with the Summer 2019 quarterly update from Childcare Advocates.

LPA also discussed Provider Information Notice regarding the recalls of Fisher-Price “Rock N’ Play Sleepers and Rocking Sleepers. LPA advised licensee that the products have been recalled due to a high amount of infant deaths, and advised licensee to immediately stop using the products.

Licensee provided LPA with their email for the purpose of being added to the Childcare Advocates distribution of quarterly newsletters.

No deficiencies were issued during today’s inspection.

This report was reviewed with licensee, and an exit interview was conducted. A Notice of Site Visit was provided and should remain posted for 30 days.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

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