313621717-6-4-2019-03-CC-ABLI-BCTMHT-20190604093803

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 313621717
Report Date: 06/04/2019
Date Signed: 06/04/2019 09:38:09 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:	SOTO HORWITZ, ADRIANA		FACILITY NUMBER:	313621717
ADMINISTRATOR:	SOTO HORWITZ, ADRIANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 510-1662
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95677
CAPACITY:	14	CENSUS: 9	DATE:	06/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Adriana Soto Horwitz		TIME COMPLETED:	10:00 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 arrived unannounced for a random annual inspection. LPA was met by Adriana Soto Horwitz. LPA toured areas of the home accessible to children in care. Off-limit areas: all bedrooms, rear hall bathroom, laundry room and garage. Licensee acknowledged that children may never enter these off-limit areas. The census included 9 children all over age two. Also present was licensee’s assistant Beatriz. Licensee stated there are no new residents in the home since licensure. Adult residents have criminal record clearances. LPA observed CPR/First Aid certificates expiring on 2/2021. LPA discussed upcoming infant sleep regulations and recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed some children’s files. LPA observed fire drills were conducted at least once every six months and documented. LPA observed that there were no hazardous items accessible to children. Fireplace is screened. LPA observed cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Fire extinguisher and smoke detector meet regulation. There is a working carbon monoxide detector present. Toys appear to be safe. The backyard is fenced and gated. There is an in ground pool on the property which is completely surrounded by a see through mesh fence that is at least 5 feet high. There are no windows or doors that provide direct access into the pool area.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

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: SOTO HORWITZ, ADRIANA	FACILITY NUMBER: 313621717
	VISIT DATE: 06/04/2019

NARRATIVE

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IMS (Not providing at this time) 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

Mandated Reporter Training

LPA advised the licensee on the new regulation AB 1207- California Child Care Worker: Mandated Reporter Training. The licensee and staff must complete the training every two years starting January 1, 2018 and retain proof of completion in the facility file. The training can be can be found at: mandatedreporterca.com. LPA observed licensee and Beatriz certificate for Mandated Reporter training.

Staff records were reviewed to contain TB and proof of immunization to measles, pertussis and flu.

LPA provided the Community Care Licensing’s 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. LPA advised there is a provider meeting to be held September 4, 2019 at PCOE office in Rocklin.

There are no Title 22 Deficiencies cited during today’s visit.

Licensing report was reviewed and discussed with licensee. Notice of Site Visit Posted.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2019

LIC809 (FAS) - (06/04)

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