343618665-9-12-2019-53-CC-FDIZ-BFXP2B-20190912105541

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343618665
Report Date: 09/12/2019
Date Signed: 09/12/2019 10:55:52 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:	MCCUBBIN-TAYLOR, MARYANN		FACILITY NUMBER:	343618665
ADMINISTRATOR:	MCCUBBIN-TAYLOR, MARYANN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 309-5273
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95757
CAPACITY:	14	CENSUS: 11	DATE:	09/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Maryann MCCubin-Taylor		TIME COMPLETED:	11:05 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 Analysts (LPAs) Fabiola Diaz and Jeevun Birk-Miller met with licensee Maryann MCCubin-Taylor for an unannounced random annual inspection and toured areas of the home accessible to children in care. During the visit the licensee's husband/assistant and a friend of the licensee were present during the inspection. The licensee's visitor was there for the morning and left the facility after the LPAs arrival. Off-limit areas include garage and all upstairs. Licensee acknowledged that children may never enter these off-limit areas. The home is a two story home with one bedroom and one bathroom downstairs used by children in care. The census included 11 children. Licensee stated there are no new residents in the home since licensure. All Adult residents have criminal record clearances. LPAs observed current CPR/First Aid certificates which expire on 2/2020. LPAs discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPAs reviewed 6 children’s files. LPAs observed fire drills were conducted at least once every six months and documented. LPAs observed that there were no hazardous items accessible to children. LPAs observed a fireplace in the home that was properly barricaded. LPAs 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 is no bodies of water on the grounds. Report continues on 809-C.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2019

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: MCCUBBIN-TAYLOR, MARYANN	FACILITY NUMBER: 343618665
	VISIT DATE: 09/12/2019

NARRATIVE

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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.
LPAs discussed recent changes in licensing requirements, including SB 277 (no longer accepting religious beliefs for immunization's) and SB 792 pertaining to immunization requirements for children and staff - Licensee provided proof of staff immunization's.

LPAs discussed the new Mandated Reporter Training with licensee. Volunteers are encouraged but not required to take the training. LPAs observed completion certificates in files in facility that expire on 3/18/2020.

LPAs provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPAs advised licensee of their responsibility to stay current in regards to new regulations. LPAs discussed proposed changes in sleep regulations with licensee and provided the brochure. LPAs discussed the Effects of Lead Brochure.

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

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2019

LIC809 (FAS) - (06/04)

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