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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619798
Report Date: 05/10/2019
Date Signed: 05/10/2019 12:04:50 PM

COMPREHENSIVE INSPECTION
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:FARREN, MEGANFACILITY NUMBER:
343619798
ADMINISTRATOR:FARREN, MEGANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 215-8170
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY:14CENSUS: 15DATE:
05/10/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Megan FarrenTIME COMPLETED:
12:15 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Tanya Washington and Rosie Pitts met with Licensee, Megan Farren for the purpose of an unannounced annual random inspection. Upon arrival LPAs observed two assistants supervising 13 preschoolers and 2 infants in the home. Licensee arrived to the facility within 20 minutes from LPAs arrival. All individuals subject to criminal background review have obtained a criminal record clearance. Facility operates Monday- Friday from 7:30 a.m to 5:30 p.m.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the daughters bedroom, master bedroom, and outside sheds. Licensee understands that children may not have access to off limit areas of the home. LPAs observed a working phone, 3A40BC fire extinguisher, and functioning smoke and carbon monoxide detectors. Licensee stated there are no weapons in the home. Toxic and hazardous items are inaccessible to children. Safe toys were observed. Licensee understands that 100% supervision is required in unfenced areas. There are no bodies of water on the premises.

LPAs conducted a file review for all children present during today's inspection, 3 out of 15 children were missing a file and some children's files were incomplete. Licensee was provided a list of children who had an incomplete/ missing file. Licensee's CPR and First aid certification expires 11/17/2019. Licensee did not have proof of CPR and First aid for the assistants who were with the children today.

Report continues on 809-C.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
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: FARREN, MEGAN
FACILITY NUMBER: 343619798
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/13/2019
Section Cited
CCR
102416.5
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Staffing Ratio and Capacity. The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. This requirement is not met as
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The Licensee agrees to submit a written plan of correction with a schedule for children in care to be within capacity specified on the license. The written schedule is required within 24 hours.
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evidenced by: LPAs observed 13 preschool children and 2 infants in care. There were no school age children present.
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An unannounced follow up inspection will be conducted by LPA to ensure that the Licensee is in compliance with ratio and capacity.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
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: FARREN, MEGAN
FACILITY NUMBER: 343619798
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/10/2019
Section Cited
CCR
102421(a)
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The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d). This requirement was not met as evidenced by:
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Licensee was provided a list of required documents for children's records (LIC311D) and also a list of children's names who had a missing/ incomplete file.
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LPAs conducted file review of children's files and observed 3 out of 15 children missing a file and some children's files are incomplete.
This is a potential risk to the health and safety of children in care.
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LPA will return after 06/10/2019 to clear the citation.
Type B
06/10/2019
Section Cited
CCR
102416(c)
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The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid,
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Licensee stated that she will ensure that her assistants are CPR and First Aid certified by POC date of 06/10/2019.
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pursuant to Health and Safety Code Section 1596.866. This requirement was not met as evidenced by: Upon arrival Licensee was not present in the home, both assistants who were supervising the children did not have required EMSA certified CPR and First aid.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: FARREN, MEGAN
FACILITY NUMBER: 343619798
VISIT DATE: 05/10/2019
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. Licensee stated she does not administer IMS. 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

Annual fees are currently paid in full. LPAs observed required AB1207 mandated reporter traning for the Licensee and assistants. Licensee is aware that the certification must be renewed every 2 years.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPAs also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list. childcareadvocatesprogram@dss.ca.gov.

This report was reviewed and discussed with the Licensee. Appeal rights were provided and an exit interview was conducted.

Upon receipt, licensee shall post and provide copies of this licensing report to parents/ guardians of children who are currently enrolled as well as parents/ guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must acknowledge receipt of this report and citation by signing a LIC 9224, “ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS”. A copy of this form should be placed in each child file upon receipt from parent.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: FARREN, MEGAN
FACILITY NUMBER: 343619798
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/10/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/10/2019
Section Cited
CCR
102417(9)(A)
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Each family child care home shall conduct fire drills and disaster drills at least once every six months.
This requirement is not met as evidenced, LPAs observed that the last drill was conducted in July, 2017.
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Licensee will ensure to conduct a drill by POC date of 06/10/2019.

Proof can be submitted via e-mail.
Type B
06/10/2019
Section Cited
HSC
1597.622(a)(1)
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(a) (1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles.
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Licensee stated that she will ensure that her assistants files are complete by POC date of 06/10/2019.
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Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced, LPAs did not observe proof of required vaccines for the assistants.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5744
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 05/10/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019
LIC809 (FAS) - (06/04)
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