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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313609057
Report Date: 09/12/2019
Date Signed: 09/13/2019 07:25:52 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:WINTER, JENNIFERFACILITY NUMBER:
313609057
ADMINISTRATOR:WINTER, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 632-7971
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY:14CENSUS: 9DATE:
09/12/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Jennifer WinterTIME COMPLETED:
02:35 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jeremey McClain met with licensee Jennifer Winter for an unannounced annual/random inspection. LPA observed a census of nine children, which included three infants and six preschool age children. Licensee stated there aren’t new residents in the home. Licensee’s assistants were present during today’s inspection. All adult residents currently have criminal record clearances.

LPA toured areas of the home accessible to the children. The upstairs is off-limits. The stairs are properly barricaded to prevent access

LPA observed that the licensee’s CPR/First Aid Certification has expired as of 03/2019. LPA provided licensee with link: https://emsa.ca.gov/childcare_provider1/, in order find a provider to obtain current CPR/First Aid Certification. 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. There is a working telephone 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. Licensee has a pool that is fenced properly according to regulation. REPORT CONTINUED ON THE FOLLOWING PAGE.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: WINTER, JENNIFER
FACILITY NUMBER: 313609057
VISIT DATE: 09/12/2019
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 11/2019. 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.

Deficiencies are noted on the subsequent page of this report an if not corrected, pose a potential risk to the health and safety of children in care.



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 PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: WINTER, JENNIFER
FACILITY NUMBER: 313609057
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/12/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/12/2019
Section Cited

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...Licensees of family day care homes shall ensure that at least one staff member who has a current course completion card in pediatric first aid and pediatric CPR issued by the American Red Cross, the American Heart Association, or by a training
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program that has been approved by the Emergency Medical Services Authority pursuant to this section and Section 1797.19. This requirement was not met. Licensee's CPR/First Aid certification expried as of 03/18/2019. This is a potential risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClainTELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:
DATE: 09/12/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/12/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3