343618416-8-23-2019-03-CC-JHOA-BFBPS3-20190823113339

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343618416
Report Date: 08/23/2019
Date Signed: 08/23/2019 11:33:45 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:	MATOS, SANDY		FACILITY NUMBER:	343618416
ADMINISTRATOR:	MATOS, SANDY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 467-7485
CITY:	RANCHO CORDOVA	STATE: CA	ZIP CODE:	95742
CAPACITY:	14	CENSUS: 10	DATE:	08/23/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Sandy Matos		TIME COMPLETED:	12:00 PM

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), Jan Hoshida, met with Licensee, Sandy Matos, for an unannounced random annual inspection and toured areas of the home accessible to children in care. Off-limit areas include garage, laundry room, all three bedrooms and the right and left side yards. Licensee acknowledged that children may never enter these off-limit areas. The census included ten children. Also present was Licensee’s assistant. Licensee stated there are no new residents in the home since licensure. All adult residents have criminal record clearances. The hours of operation are Monday through Friday from 7:00am to 5:45pm. LPA discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed some children’s files. LPA observed fire drills were conducted once a month and documented. LPA observed that there were no hazardous items accessible to children. LPA observed fireplace which was screened. LPA observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Fire extinguisher, smoke detector and carbon monoxide detector meet regulation. Toys appear to be safe. The backyard is fenced and gated. There are no bodies of water observed. 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. *REPORT CONTINUED ON NEXT PAGE*

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2019

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: MATOS, SANDY	FACILITY NUMBER: 343618416
	VISIT DATE: 08/23/2019

NARRATIVE

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LPA discussed the new Mandated Reporter Training with Licensee. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. In addition, existing Licensees must meet requirements by March 30, 2018. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: HTTP://WWW.MANDATEDREPORTERCA.COM/. The training is currently provided in English. AB1207 Training. LPA observed current Mandated Reporter Training in file.

LPA checked facilities fees and confirmed that it is up to date.

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 in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws CHILDCAREADVOCATESPROGRAM@DSS.CA.GOV.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the Licensee and provided copies along with Appeal Rights. An exit interview was conducted. LPA observed the Notice of Site Visit posted and the Licensee understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Jan Hoshida	TELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2019

LIC809 (FAS) - (06/04)

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