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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313609166
Report Date: 08/13/2019
Date Signed: 08/13/2019 01:21:13 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:WERNLI, KATHLEENFACILITY NUMBER:
313609166
ADMINISTRATOR:WERNLI, KATHLEENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 223-9160
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:14CENSUS: 10DATE:
08/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Kathleen Wernli - LicenseeTIME COMPLETED:
02:00 PM
NARRATIVE
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An unannounced annual/random inspection is made today by LPA Katrina Owens. Present at time of inspection were licensee, her assistant and 10 day care children. Ages of children present were 2,1,4,3,4,4,3,3,1 and 1 years old. Licensee is not a Foster Parent, nor have any other licenses.

A tour of the home, inside and outside, as shown on the facility sketch is conducted. Staff were spoken to during inspection; children were napping. Licensee states there are no weapons or firearms in the home. Swimming pool is fenced per regulation. LPA observed poisons, cleaning compound's, medications and other hazardous items are inaccessible to children. Fireplace contains a screen, and is inaccessible to children. Fire extinguisher, Carbon Monoxide detector and smoke detector meets regulations. Currently, licensee does have 2 dogs. She chooses to allow the dogs to have access to day care children and she is aware that she is responsible for child safety around pets at all times. Stairs are barricaded when children under age 5 years old are present. Toys and play equipment appear to be safe. There is a working telephone. Adequate supervision is being provided during this inspection. Licensee stated she does not administer medication at this time.

The capacity as specified on the license is being maintained. Staff-child ratios are maintained. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Pediatric CPR/FA is current with expiration date of 2/2020. A child roster is maintained. Fire and disaster drills are conducted every six months and documented. Some staff and children records reviewed.
LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.

Continued on Page 2

SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
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: WERNLI, KATHLEEN
FACILITY NUMBER: 313609166
VISIT DATE: 08/13/2019
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LPA discussed the required mandated reporter training to be taken at website: www.mandatedreporterca.com before 3/1/2018.

LPA discussed the new Safe Sleep in Child Care regulation and gave licensee the brochure.

Off-limit rooms are: Garage and Entire upstairs. Licensee acknowledges that children may never enter these off-limit areas. Observed tool shed in backyard behind a fence making shed inaccessible to children. During the exit interview, LPA discussed AB 633, Parent Notification Requirements, and the posting of licensing inspection notices and reports. Hours of operation are 7:00 AM to 5:30 PM; Monday thru Friday and other hours as arranged. Licensee states she does not transport children.



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. 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 provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, NO deficiencies are observed today. This report was reviewed and discussed
with licensee at time of inspection. Licensee have read and understands the content of this report.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina OwensTELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2