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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618991
Report Date: 07/23/2019
Date Signed: 07/23/2019 10:27:04 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:SWANSON, KATHERINEFACILITY NUMBER:
343618991
ADMINISTRATOR:SWANSON, KATHERINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 419-9784
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:14CENSUS: 8DATE:
07/23/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Katherine SwansonTIME COMPLETED:
10:45 AM
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Licensing Program Analysts (LPAs) Joleen Kenney and Karyn Guerra met with the licensee, Katherine Swanson, for the purpose of an unannounced annual random inspection. The licensee's husband (assistant), and son were also present during the inspection. All individuals subject to criminal background review have obtained a criminal record clearance. Hours of operation for the facility are 7:00AM-6:00PM, Monday thru Friday. Census at the time of inspection was 8 children including 6 preschool, 1 Kindergarten, and 1 First Grade child(ren).

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the Garage, Laundry room, Office, and Upstairs. Licensee acknowledged that children must never enter these areas. LPA reviewed the required postings, observed a working phone, 2A10BC fire extinguisher, and functioning smoke and carbon monoxide detectors. Licensee stated there are no weapons in the home. There is a fenced pool on the premises with a gate that self closes and swings away from the pool. LPA will follow up with management regarding locked windows in the home facing the pool. Toxic and hazardous items are inaccessible to children. Stairs and fireplace are appropriately barricaded to prevent access by children, and outdoor play space is fenced.

Children’s files were reviewed. LPA reviewed immunization records and observed signed Family Child Care Home Notification of Parents' Rights in children's files. LPAs reviewed maintenance of a facility roster, and observed documentation of fire and disaster drills. The licensee's immunization records for pertussis (Tdap), and the flu are available in the facility file. Current in person EMSA CPR and First Aid certification was verified and expires 8/2019 and AB 1207 Mandated Reporter Training was reviewed.

Report continues on 809-C.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 216-7796
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
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: SWANSON, KATHERINE
FACILITY NUMBER: 343618991
VISIT DATE: 07/23/2019
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This provider is currently not providing IMS services to children in care. 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: https://www.ada.gov/childqanda.htm.

LPA verified that the annual fees are current. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so the licensee can request to be added to the distribution list to receive Quarterly Updates. LPA provided and discussed the Safe Sleep in Child Care and Effects of Lead Exposure brochures.

This facility evaluation report was reviewed and discussed with the licensee. A Notice of Site Visit was provided and should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at WWW.CDSS.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 three years for public review upon request. The licensee's signature on this form acknowledges receipt of this form.



In the areas that were evaluated, no deficiencies were observed at the time of the visit.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 216-7796
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
LIC809 (FAS) - (06/04)
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