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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618339
Report Date: 02/16/2023
Date Signed: 02/16/2023 11:29:57 AM


Document Has Been Signed on 02/16/2023 11:29 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833



FACILITY NAME:JONES, MICHELLEFACILITY NUMBER:
343618339
ADMINISTRATOR:JONES, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 483-8774
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:14CENSUS: 7DATE:
02/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Michelle JonesTIME COMPLETED:
11:30 AM
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Licensing Program Analysts Jennifer Velasco and Erwina Pascual-Golamco (LPAs) conducted an unannounced annual inspection and met with Licensee Michelle Jones (L1). LPAs observed seven children in care with L1 and an assistant. Facility hours of operation are Monday through Friday 7:30 AM - 5:30 PM. LPAs observed that the annual facility fees are current.

L1 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Off limit areas include: all rooms and bathrooms on second and third floors, (gated) stairs, combination locked shed, and garage. L1 acknowledged that children may never enter these off-limit areas. LPAs conducted a health and safety inspection and observed that the facility is clean, safe, sanitary, and in good repair with ventilation. LPAs observed the required documents were posted where visible to parents. LPAs observed that there were no hazardous items accessible to children including cleaning compounds, medications, or sharp objects. Fire extinguisher is in working condition and accessible. LPAs observed the smoke and carbon monoxide detectors are functioning properly. The facility has adequate toys that are safe for children to use. The backyard is fenced and L1 acknowledged that in areas that are not fenced, 100% supervision is required. LPAs observed the backyard pool is fenced and gated compliant with regulatory requirements.. LPAs verified all guns are in a key locked safe and stored separately from ammunition, which is stored in a different key locked safe.

LPAs observed a current children's roster and fire drill log. LPAs reviewed children’s files and observed that all the required documentation was present in each child's file. LPAs observed the CPR/First Aid certificate was current. LPAs observed a current Mandated Reporter certificate for L1 and assistant(s). L1 was reminded the Child Care portion must be completed every two years. LPAs reviewed staff and facility files and observed the required documentation.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-GolamcoTELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: JONES, MICHELLE
FACILITY NUMBER: 343618339
VISIT DATE: 02/16/2023
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Though L1 stated she does not currently enroll infants, LPAs discussed with L1 the safe sleep regulations and the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPAs also informed L1 of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services- IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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. LPAs discussed current COVID guidelines with L1 and provided technical assistance.

LPAs discussed current COVID guidelines with L1 and provided technical assistance. LPAs provided the Department’s website WWW.CCLD.CA.GOV, so the L1 can obtain updated licensing information, new regulations and access forms. LPA advised L1 of their responsibility to stay current by reviewing PINs on the website.

There were no citations issued during today's inspection. A notice of site visit was given to L1 and must remain posted for 30 days. Exit interview was conducted and report was reviewed with L1.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 584-3508
LICENSING EVALUATOR NAME: Erwina Pascual-GolamcoTELEPHONE: (916) 206-1524
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
LIC809 (FAS) - (06/04)
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