313617353-12-6-2019-03-CC-KOWS-BJLR7U-20191206114654

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313617353
Report Date: 12/06/2019
Date Signed: 12/06/2019 11:46:59 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:	NELSON, LAILOMA		FACILITY NUMBER:	313617353
ADMINISTRATOR:	NELSON, LAILOMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 425-4502
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95747
CAPACITY:	14	CENSUS: 10	DATE:	12/06/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Lailoma Nelson - Licensee		TIME COMPLETED:	12:00 PM

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An unannounced annual/random inspection is made today by LPA's Katrina Owens and Lea Habtom. Present at time of inspection were licensee, her husband Daniel and 10 day care children. Ages of children present were 3,2,2,3,2,3,2,4,3 and 8 months old.

A tour of the home, inside and outside, as shown on the facility sketch is conducted. Staff and Children were spoken to during inspection. There are no "bodies of water" at this home. LPA observed a small bird bath in the front yard with a small amount of water; bird bath was not a drowning hazard to children. Licensee states there are no weapons or firearms in the home. LPA observed poisons, cleaning compound's, medications and other hazardous items are inaccessible to children. There is no fireplace. Fire extinguisher, Carbon Monoxide Detector and Smoke Detector meets regulations. There are no pets observed today. Stairs are barricaded when children under age 5 years old are present. Toys and play equipment that were observed appear to be safe. There is a working telephone. Adequate supervision is being provided during this inspection. Children are supervised when outside in the unfenced play area.

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 10/27/2020. A child roster is maintained. Fire and disaster drills are conducted every six months and documented. Children records reviewed.

LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.

LPA observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com

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SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2019

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: NELSON, LAILOMA	FACILITY NUMBER: 313617353
	VISIT DATE: 12/06/2019

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LPA discussed the new Safe Sleep in Child Care regulation. She already had the Safe sleep brochure. LPA discussed and gave licensee the Effects of Lead Exposure brochure.

This facility is not providing Incidental Medical Services-IMS at this time. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family child care home evaluator manual (FCCH EM) Policy 102417.

Off-limit rooms are: Entire upstairs and garage. Licensee acknowledges that children may never enter these off-limit areas. Swing set observed and is anchored into ground. 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 5:00 PM; Monday thru Friday and other hours as arranged. Licensee states she does not transport children.

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.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAY

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2019

LIC809 (FAS) - (06/04)

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