343619232-8-2-2019-53-CC-ASIA-BENNZS-20190802105449

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343619232
Report Date: 08/02/2019
Date Signed: 08/02/2019 10:54:56 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:	SOBELMAN, MICHELLE & TIMOTHY		FACILITY NUMBER:	343619232
ADMINISTRATOR:	SOBELMAN, MICHELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 714-9595
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	14	CENSUS: 14	DATE:	08/02/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Alicia Henzie		TIME COMPLETED:	11:20 AM

NARRATIVE

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Licensing Program Analysts (LPAs) Amy Silva & Alecia Sifuentes met with Teacher, Alicia Henzie for an unannounced random annual inspection. Also present at time of visit was one assistant, Jessica Bias and 14 day care children, ages 9 months, 1, 1, 2, 2, 3, 3, 3, 4, 4, 4, 5, 5, and 7 years old.

A tour of the home, inside and outside, as shown on the facility sketch was conducted. Children were playing outside during the visit. Swimming pool is fenced per regulation. Teacher states there are no weapons or firearms in the home. LPAs observed poisons, cleaning compound's, medications and other hazardous items are inaccessible to children. Fire extinguisher, carbon monoxide detector and smoke detector meet regulations. Safe toys and play equipment are observed. There is a working telephone. Adequate supervision is being provided during this visit.

The capacity as specified on the license is being maintained. Staff-child ratios are maintained. All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Pediatric CPR/FA is current for all staff who are present at today’s inspection. Mandated reporter training is current. A child roster is maintained. Fire and disaster drills are conducted once a month and documented on 7/17/2019. Four Children’s records were reviewed.

LPA reviewed with licensee the handouts “A Child Care Provider’s Guide to Safe Sleep” and “Safe Sleep Regulation Concepts” and "Lead Poisoning Facts."

Report continues on 809C

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019

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: SOBELMAN, MICHELLE & TIMOTHY	FACILITY NUMBER: 343619232
	VISIT DATE: 08/02/2019

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Off-limit rooms are: the entire main house and the back yard that has the swimming pool. Teacher acknowledges that children may never enter these off-limit areas. Swing set / jungle gym observed in back yard and is anchored into ground. Observed tool shed and it locked . During the exit interview, LPAs discussed AB 633, Parent Notification Requirements, and the posting of licensing inspection notices and reports. Hours of operation are 7:00 AM to 5:30 PM; Monday thru Friday and other hours as arranged. Licensee states she does transport children.

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 provided the Community Care Licensing 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 regard to new regulations. LPAs 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. LPAs reviewed report with the Teacher and provided copies. An exit interview was conducted. Appeal rights provided. Notice of Site Visit was provided, and Licensee understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2019

LIC809 (FAS) - (06/04)

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