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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618356
Report Date: 05/02/2019
Date Signed: 05/02/2019 10:19:21 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:STUART, JENNIFERFACILITY NUMBER:
343618356
ADMINISTRATOR:STUART, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 353-1136
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY:14CENSUS: 10DATE:
05/02/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Jennifer Stuart, LicenseeTIME COMPLETED:
10:30 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Kelly Ferrara and Mai Lor met with Licensee Jennifer Stuart, for an unannounced random annual inspection of her large family child care home. All adults who live or work in the home have obtained a criminal record clearance. Hours of operation are Monday, Wednesday, and Thursday from 8:45 AM- 11:35 AM. Licensee stated she is closed for the summer. There were ten children present at the time of inspection with an assistant present.

A health and safety inspection was conducted in all areas accessible to children. Off limit areas include: entire upstairs, laundry room, garage, and backyard hillside. LPA observed a working phone, 2A10BC fire extinguisher, screened fireplace, first aid kit, and functioning smoke and carbon monoxide detectors that meet regulations. LPA observed a fire drill log with the last drill conducted in March 2019. LPAs observed all of the required licensing documents were posted for parental review and a current children's roster was observed. Licensee has Child Care Liability Insurance. Knives, medications, and chemicals were all stored inaccessible to children. Licensee stated that there are no firearms in the home and there were no bodies of water observed on the premises.

All children and staff files reviewed contained the required documentation. Licensee's CPR/First Aid expired in June 2018 and she was not able to provide proof of a current certification.

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 EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5935
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
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 3
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: STUART, JENNIFER
FACILITY NUMBER: 343618356
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/03/2019
Section Cited
CCR
102416(c)
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The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.
This requirement was not met as evidenced by: LPAs were not able to observe a current
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Licensee shall provide proof of registration in an EMSA certified CPR/First Aid course or proof of certification by POC due date.
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CPR/First Aid certificate. This poses a potential health and safety risk to children in care.
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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: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5935
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: STUART, JENNIFER
FACILITY NUMBER: 343618356
VISIT DATE: 05/02/2019
NARRATIVE
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The facility evaluation report was reviewed and discussed with the Licensee. Notice of site visit was provided and it must remain posted for 30 days for parental review. 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.

One Type B citation was issued during today's inspection.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5935
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3