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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343610866
Report Date: 12/12/2019
Date Signed: 12/12/2019 11:28:25 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:FAMILY MATTERS CHILD CARE CENTERFACILITY NUMBER:
343610866
ADMINISTRATOR:NELSON, GINAFACILITY TYPE:
830
ADDRESS:5452 14TH AVE.TELEPHONE:
(916) 457-4067
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY:16CENSUS: 7DATE:
12/12/2019
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Danielle RobertsTIME COMPLETED:
11:45 AM
NARRATIVE
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Licensing Program Analysts Tanya Washington and Joleen Kenney met with Director Danielle Roberts for a case management inspection. Upon arrival LPAs toured the infant room and observed Staff #1 who identified themselves as a lead teacher caring for 4 infants in the main activity space. Staff #2 was caring for 3 younger awake infants in the napping area which should strictly be designated and used for cribs and napping equipment. Staff #2 identified themselves as an aide who was covering a break for another staff member. LPAs conducted a file review for Staff #1 and learned that Staff #1 does not have qualifications for an infant teacher.

Two Type A citations are cited on the following LIC809D. Appeal rights provided.

Upon receipt, licensee shall post and provide copies of this licensing report to parents/ guardians of children who are currently enrolled as well as parents/ guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must acknowledge receipt of this report and citation by signing a LIC 9224, “ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS”. A copy of this form should be placed in each child file upon receipt from parent.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

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

DATE: 12/12/2019
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: FAMILY MATTERS CHILD CARE CENTER
FACILITY NUMBER: 343610866
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/12/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/13/2019
Section Cited

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Prior to employment, an infant care teacher shall have completed, with passing grades, at least three post secondary semesters or equivalent quarter units in early childhood education or child development, and three post secondary semester or equivalent quarter units related to the care of infants, at an accredited or approved college or university. This requirement is not met as evidenced by; Upon file review of Staff #1 LPAs learned that the staff member does not have the credentials to be an infant teachers. This is an immediate risk to the health and safety of children in care.
Type A
12/13/2019
Section Cited

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The sleeping area for infants shall be physically separate from the indoor activity space. This separation shall be accomplished as specified in (b) above. This requirement is not met as evidenced by; LPAs observed Staff #2 providing care to 3 infants who were awake and playing in the napping area.

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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: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:
DATE: 12/12/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/12/2019
LIC809 (FAS) - (06/04)
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