343619354-2-1-2023-03-CC-JGAG-CNMSKB-20230201125628

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343619354
Report Date: 02/01/2023
Date Signed: 02/01/2023 12:56:38 PM

Document Has Been Signed on 02/01/2023 12:56 PM - 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:	VIENNA, RENA & SHEILA		FACILITY NUMBER:	343619354
ADMINISTRATOR:	VIENNA, RENA & SHEILA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 922-4810
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95825
CAPACITY:	14	CENSUS: 10	DATE:	02/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Sheila Vienna		TIME COMPLETED:	01:10 PM

NARRATIVE

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On February 1, 2023 at approximately 11:00 AM, Licensing Program Analyst (LPA) Josiah Gathing met with licensee Sheila Vienna for the purpose of a required annual inspection. The facility days and hours of operation are Monday – Friday 6:30 AM to 5:30 PM. During today’s inspection, there were 10 day care children present. All individuals subject to criminal background review have obtained a criminal record clearance.

A health and safety evaluation was conducted in all areas accessible to children. Off-limits areas of the home include: Bathroom near the bedrooms and detached garage. LPA observed a full 2A10BC fire extinguisher, first aid kit, and functioning smoke and carbon monoxide detectors in the home. Per licensee, there are no weapons in the home. Poisons are locked in the off-limits detached garage. LPA observed required posted documents.

During file review, LPA observed all necessary Children’s documents. LPA observed current facility roster and fire drill log last updated December 2022. LPA observed and CPR/First Aid certificates which will expire March 2024. Additionally, LPA observed Licensee’s Mandated Reporter training certificate which will expire February 2024.

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 followinginformation regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA available at: http://wwwada.gov/childqanda.htm

CONTINUED ON LIC809-C…

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Josiah Gathing	TELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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: VIENNA, RENA & SHEILA	FACILITY NUMBER: 343619354
	VISIT DATE: 02/01/2023

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Applicant was reminded that all adults 18 and over living or working in the home, 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 Family Child Care Home. 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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 they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and report was reviewed with the Licensee, Sheila Vienna. This report and appeal rights were printed and provided to the Licensee.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Josiah Gathing	TELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC809 (FAS) - (06/04)

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