343618090-2-20-2020-03-CC-MBED-BLYQQ4-20200220112142

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343618090
Report Date: 02/20/2020
Date Signed: 02/20/2020 11:22:00 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:	FITZ, BRENDA		FACILITY NUMBER:	343618090
ADMINISTRATOR:	FITZ, BRENDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 761-3233
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95841
CAPACITY:	14	CENSUS: 5	DATE:	02/20/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Brenda Fitz		TIME COMPLETED:	11:30 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) Marea Behvand met with Licensee, Brenda Fitz, for the purpose of an unannounced annual random inspection. The licensee's minor child and Assistant/daughter were also present during the inspection. All individuals subject to criminal background review have obtained a criminal record clearance. A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the master bedroom/bathroom, bedroom #3, and laundry room. The home previously had bedroom #2 off-limits, however, licensee requested to make the room on-limits. LPA inspected the room and effective today, Bedroom #2 is on-limits. Also, previously the backyard had a hot tub that has since been removed. Licensee requested to make the backyard on-limits. LPA inspected the backyard, and effective today, the backyard is on-limits. The backyard is completely fenced. LPA observed the required postings, a working phone, 3A40BC fire extinguisher, and functioning smoke and carbon monoxide detectors. Licensee stated there are no weapons in the home. Toxic and hazardous items are inaccessible to children. A magnet latch is in use on the knife drawer in the kitchen. The fireplace in the home is appropriately barricaded to prevent access by children. Five children’s files were reviewed during today's inspection. A current roster is being maintained and fire and disaster drills are documented. CPR and First Aid certification was verified and expires 09/14/2021 and AB1207 Mandated Reporter Training was verified and expires 03/08/2020. Licensee was informed about the new General portion that is required to be taken in addition to the For Child Care Provider portion per AB1207. Report continues on 809-C.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Marea Behvand	TELEPHONE: (916) 216-7793
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020

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: FITZ, BRENDA	FACILITY NUMBER: 343618090
	VISIT DATE: 02/20/2020

NARRATIVE

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This provider is currently not providing IMS services to children in care. 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 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 Safe Sleep in Child Care and Effects of Lead Exposure brochures.

This facility evaluation report was reviewed and discussed with Licensee. A Notice of Site Visit was provided and should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at WWW.CDSS.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request. The licensee's signature on this form acknowledges receipt of this form.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Marea Behvand	TELEPHONE: (916) 216-7793
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2020

LIC809 (FAS) - (06/04)

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