313609654-12-10-2019-03-CC-ABLI-BJQMWM-20191210085833

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313609654
Report Date: 12/10/2019
Date Signed: 12/10/2019 08:58:38 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:	COLLAMER, PETRA		FACILITY NUMBER:	313609654
ADMINISTRATOR:	COLLAMER, PETRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 786-9836
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95677
CAPACITY:	14	CENSUS: 12	DATE:	12/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Petra Collamer		TIME COMPLETED:	09:15 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) Amanda Blesi met with the Licensee, Petra Collamer for the purpose of an unannounced Annual inspection. The Licensee's assistant, Kathleen Lau, was also present upon arrival. LPA asked if anyone else was present in the home today and licensee stated no. All individuals subject to criminal background review have obtained a criminal record clearance. Children began arriving during the visit and the census was 12 children all over age two years old. A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the Master bedroom and deck. Licensee acknowledged that children may never enter these off-limit areas. LPA observed a working phone, fire extinguisher, and functioning smoke and carbon monoxide detectors. Licensee stated there are no weapons in the home. Toxic and hazardous items (detergents, cleaning compounds, medications, sharp utensils, items that could pose a danger to children in care) are properly stored and inaccessible to children. The fireplace in the home is appropriately barricaded to prevent access by children. Stairs were barricaded. Safe toys and play equipment are observed. The outdoor play space is fenced. The backyard is fenced and gated. There is a seasonal creek on the property which is barricaded by a wrought iron fence that is at least 5 feet high. LPA observed the gate to self-close and self-latch. Some children’s files were reviewed. A current roster is being maintained. Licensee fire and disaster drills are conducted and documented. CPR and first aid training were verified. Mandated Reporter Training (AB 1207) for Licensee/Assistant was also verified.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

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: COLLAMER, PETRA	FACILITY NUMBER: 313609654
	VISIT DATE: 12/10/2019

NARRATIVE

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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 verified the annual fees are current. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so the Licensee can request to be added to the distribution list to receive Quarterly Updates.

LPA provided and discussed the Lead Testing brochure (AB 2370) and updated Blue Immunization Cards (CDPH 286)

LPA reviewed and discussed this facility evaluation report with the Licensee. LPA provided a Notice of Site Visit and the Licensee acknowledges that this notice should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at http://ccld.ca.gov for child care updates, current forms, legislation and regulation information.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiencies are cited during today's inspection. Appeal rights provided.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

LIC809 (FAS) - (06/04)

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