343618161-10-10-2019-03-CC-KFEA-BGTN39-20191010100558

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343618161
Report Date: 10/10/2019
Date Signed: 10/10/2019 10:06:05 AM

COMPREHENSIVE INSPECTION

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:	BERRY, SHERRI		FACILITY NUMBER:	343618161
ADMINISTRATOR:	BERRY, SHERRI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 847-7132
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY:	14	CENSUS: 11	DATE:	10/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Sherri Berry		TIME COMPLETED:	10:15 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) Kelly Ferrara met with Licensee Sherri Berry for an unannounced random annual inspection of her large family child care home. All adults who live and work in the home have obtained a criminal record clearance and the annual fees are current. Hours of operation are Monday through Friday 9 AM - 3 PM. There were 11 children present at the time of inspection with the Licensee and an assistant. A health and safety inspection was conducted in all areas accessible to children. Off limit areas include: Entire upstairs. LPA observed a working phone, 2A10BC fire extinguisher, pull fire alarm, first aid kit, and functioning smoke and carbon monoxide detectors that meet regulations. LPA observed a current children's roster and fire drill log with the last drill conducted in July 2019. Knives, medications, and chemicals were all stored inaccessible to children. LPA did not observe any bodies of water on the premises and Licensee stated there are no firearms or weapons in the home. LPA conducted a staff and children's file review. The Licensee and her assistant have proof of immunizations and Mandated Reporter certification. LPA advised that this training must be completed every two years. The Licensee and the assistant have valid CPR/First Aid certificates expiring April 2021. LPA observed that all of the required documentation was present in each child's file. 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.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

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: BERRY, SHERRI	FACILITY NUMBER: 343618161
	VISIT DATE: 10/10/2019

NARRATIVE

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Effects of Lead Exposure information was given to the Licensee. The facility evaluation report was reviewed and discussed with the Licensee. Licensee was encouraged to visit the Department website at WWW.CCLD.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 3 years for public review upon request. Notice of site visit was provided and it must remain posted for 30 days for parental review.

No citations were issued based on today's inspection.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly Ferrara	TELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019

LIC809 (FAS) - (06/04)

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