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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619245
Report Date: 03/15/2023
Date Signed: 03/15/2023 11:35:50 AM


Document Has Been Signed on 03/15/2023 11:35 AM - It Cannot Be Edited

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:RABON, RITAFACILITY NUMBER:
343619245
ADMINISTRATOR:RABON, RITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 745-2995
CITY:GALTSTATE: CAZIP CODE:
95632
CAPACITY:14CENSUS: 7DATE:
03/15/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Rita RabonTIME COMPLETED:
12:00 PM
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On 03/15/2023, Licensing Program Analyst Katy Maestas (LPA1) and Licensing Program Analyst Carla Palonco (LPA2) conducted a field visit to the Family Childcare Home (FCCH) for the purpose of an unannounced annual inspection. LPAs arrived at the FCCH and was met by Licensee Rita Rabon (L1). LPA1 disclosed the purpose of the inspection and was granted entrance into the FCCH. LPAs observed 2 infants, 4 preschool aged children, and 1 school aged child being supervised by 2 adults. Also present in the FCCH was L1’s spouse. LPA1 accessed Guardian to determine that all required adults were background cleared. L1 stated there are no new residents in the home since licensure. LPAs toured the areas of the FCCH that are accessible to children in care. L1 accompanied LPAs for the entirety of the tour. The OFF-limits areas of the FCCH include the bedroom 2, garage (and garage extension), and pool. L1 acknowledged that children may never enter these OFF-limits areas. L1 reports her hours of operation to be Monday through Thursday from 7:00 am until 6:00 pm and Friday from 7:00 am until 5:30 pm. L1 stated that she does not provide overnight or weekend care.

LPA1 conducted a file review before arrival at the FCCH. LPA1 provided the Entrance Checklist to L1. LPA1 discussed the required postings in a FCCH with L1 and ensured that postings are current. LPA1 reviewed the children’s files for those who were in attendance. LPA1 reviewed the adult’s files and immunizations. LPA1 observed the Facility Roster and observed the Fire Drill log to ensure that drills are conducted at least once every 6 months. A functioning smoke detector and carbon monoxide detector was observed in the hallway and tested. LPAs observed cleaners stored in kitchen cabinets that are behind doors with safety locks. LPAs observed medications stored on shelves that are out of reach for the children in care. LPAs observed knives stored in kitchen drawers that have child safety locks. The fireplace in the living room was observed to have a glass barricade; L1 stated that the fireplace is not used during operational hours. LPA observed a 2A10BC fire extinguisher in the laundry room that appeared to be in the green zone. Toys appear to be safe and in good supply. LPAs observed an in-ground pool that was surrounded by a fence that was measured at 5 feet high with a self-latching lock on the gate. Continued on 809-C
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:
DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/15/2023
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: RABON, RITA
FACILITY NUMBER: 343619245
VISIT DATE: 03/15/2023
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LPA1 walked the perimeter of the backyard and ensured the stability of the surrounding fence. L1 stated there are no weapons in the home. L1 stated that she has 1 dog who resides in the FCCH.

LPA1 discussed Mandated Reporter Training with the L1. Health and Safety Code 1596.8662 requires that all licensed providers, applicants, directors, and employees complete training as specified on their mandated reporter duties and renew their training every 2 years. Volunteers are encouraged but not required to take the training. 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 and Spanish. L1 had completed Mandated Reporter Training; however, the training has expired and was not renewed. L1 had completed Pediatric CPR and First Aid training but it is currently expired.

LPA1 discussed the Safe Sleep Regulations with L1 and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA1 also informed L1 of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov and recommended that s/he register all infant devices with the CPSC to be notified of any recalls on purchased equipment.

L1 does not currently provide Incidental Medical Services (IMS); however, the IMS policy was discussed with L1. For IMS information, see PIN 22-02-CCP. 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information through this communication platform. To receive important licensed related information, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communications. Continued on LIC 809-C

SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023
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: RABON, RITA
FACILITY NUMBER: 343619245
VISIT DATE: 03/15/2023
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L1 was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, PRIOR to initial presence in a licensed FCCH. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

L1 understands that licenses are not transferable, and once licensed, licensee must live in the home and be present for 80% of the operating hours. L1 understands that if an unusual incident occurs; licensing is to be notified via phone call, e-mail or fax within 24 hours and the Unusual Incident Report/LIC 624 shall be submitted within 7 days to remain in compliance. L1 understands that if any structural changes are made to the home; licensing must be notified PRIOR to construction. L1 understands that if she wants to make any OFF-limits area an ON-limits area, she must notify licensing and LPA must do an inspection BEFORE children are allowed in said area. L1 understands that children’s records are to be maintained according to Title 22 regulations and be accessible to licensing for up to 3 years.



If you have any questions regarding this inspection process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding this inspection and its tools and methods, please visit at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.


NO Title 22 Deficiencies were observed in the areas that were evaluated today on 03/15/2023. 3 Technical Violations were issued as a reminder to renew First Aid and CPR, to renew Mandated Reporter Training, and to complete and keep Sleep Logs in the child's file. An exit interview was conducted, and the report was reviewed with L1. LPA1 provided L1 with Licensee Appeal Rights. A Notice of Site visit was posted by LPA1 and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Nola MaestasTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2023
LIC809 (FAS) - (06/04)
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