343619579-11-18-2019-53-CC-KOWS-BJ2SLV-20191118125857

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343619579
Report Date: 11/15/2019
Date Signed: 11/18/2019 12:59:01 PM

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:	JOHNSON, DANITA		FACILITY NUMBER:	343619579
ADMINISTRATOR:	JOHNSON, DANITA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 706-7332
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95758
CAPACITY:	14	CENSUS: 7	DATE:	11/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Danita Johnson - Licensee		TIME COMPLETED:	02:25 PM

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	An unannounced annual/random inspection is made today by LPA's Owens and McClain, Present at time of inspection were licensee, her husband and 7 day care children. Ages of children present were 8,5,10,7,10,8,and 8 years old. Licensee is registered with Framax Food Program. A tour of the home, inside and outside, as shown on the facility sketch is conducted. There are no "bodies of water" at this home. No pool at the home. Licensee states there are no weapons or firearms in the home. LPA observed poisons, cleaning compound's, medications and other hazardous items are inaccessible to children. Fireplace contains a screen, and is inaccessible to children. Fire extinguisher, Carbon Monoxide detector and smoke detector meets regulations. Currently, licensee does have 2 dogs that are inaccessible to children; they are kept in the laundry room. Licensee has 2 birds that are in a cage, making the birds inaccessible to children. There is a aquarium on a stable stand and inaccessible to children. Stairs are barricaded when children under age 5 years old are present. Safe toys and play equipment appear to be safe. There is a working telephone. Adequate supervision is being provided during this inspection. The capacity as specified on the license is being 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 with expiration date of 8/30/2021. A child roster is maintained. Fire and disaster drills are conducted every six months and documented. Children records reviewed. Off-limit rooms are: Entire upstairs, Laundry Room and Garage. Licensee acknowledges that children may never enter these off-limit areas. During the exit interview, LPA discussed AB 633, Parent Notification Requirements, and the posting of licensing inspection notices and reports. Hours of operation are 6:30 AM to 6:00 PM; Monday, Tuesday, Thursday and Fridays. Wednesday closes at 5:30 PM. and other hours as arranged. Licensee states she does transport children. Continued on page 2

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019

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: JOHNSON, DANITA	FACILITY NUMBER: 343619579
	VISIT DATE: 11/15/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. Licensee is not providing IMS at this time. 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

LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.

LPA observed that all staff has completed the required mandated reporter training at website: www.mandatedreporterca.com

LPA discussed the new Safe Sleep in Child Care regulation and gave licensee the brochure. LPA discussed and gave licensee the Effects of Lead Exposure brochure.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, NO deficiencies are observed today. This report was reviewed and discussed with licensee at time of visit. Licensee have read and understands the content of this report.

THIS REPORT SHALL BE MADE AVAILABLE TO THE PUBLIC UPON REQUEST
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019

LIC809 (FAS) - (06/04)

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