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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618356
Report Date: 08/12/2021
Date Signed: 08/12/2021 01:56:19 PM

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: 0DATE:
08/12/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Jennifer StuartTIME COMPLETED:
02:00 PM
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On Thursday, August 12th, 2021, Licensing Program Analyst (LPA) Kelly Ferrara conducted an unannounced annual inspection and met with Licensee Jennifer Stuart. Licensee did not have any children in care and explained that children will be starting next week. Facility hours of operation are Tuesday and Friday 9:45 am -2:15 pm and Monday, Wednesday, and Thursday 8:45 am -3:15 pm. All adults in the home have a criminal record clearance. LPA reviewed annual fees with Licensee.

Off limit areas include: Entire upstairs, laundry room, garage, and backyard hillside. Licensee acknowledged that children may never enter these off-limit areas. LPA conducted a health and safety inspection and observed that the facility is clean, safe, sanitary, and in good repair with proper ventilation. LPA observed the proper documents were posted where visible to parents. LPA observed that there were no hazardous items accessible to children including cleaning compounds, medications, or sharp objects. LPA observed the fire extinguisher is in working condition and accessible. LPA 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 safe for children.

LPA reviewed safe sleep regulations for children under age two. LPA observed the children’s roster is current and Licensee stated she will conduct a fire drill once children start the program again. LPA reviewed children’s files and observed that all the required documentation was present in each child's file. LPA reviewed staff files with the Licensee.

Continued on 809-C

SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
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: STUART, JENNIFER
FACILITY NUMBER: 343618356
VISIT DATE: 08/12/2021
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LPA discussed Incidental Medical Services- IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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 discussed current COVID guidelines with Licensee and provided technical assistance. LPA provided the Community Care Licensing’s website WWW.CCLD.CA.GOV, so the Licensee can obtain updated licensing information, new regulations and access forms. LPA advised Licensee of their responsibility to stay current by reviewing PINs on the website.

No deficiencies cited based on today's inspection. LPA reviewed report with the Licensee. LPA observed the Notice of Site Visit posted and the Licensee understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Kelly FerraraTELEPHONE: (916) 425-5932
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
LIC809 (FAS) - (06/04)
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