343620826-2-18-2020-03-CC-ESIA-BLWRAJ-20200218115114

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343620826
Report Date: 02/18/2020
Date Signed: 02/18/2020 11:51:20 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:	WAHLSTROM, AISHA		FACILITY NUMBER:	343620826
ADMINISTRATOR:	WAHLSTROM, AISHA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 429-8856
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95823
CAPACITY:	14	CENSUS: 5	DATE:	02/18/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Aisha Wahlstrom		TIME COMPLETED:	12:10 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	Licensing Program Analyst (LPA)Elvira Sierra met with licensee, Aisha Wahlstrom, for an unannounced Annual/Random inspection. Upon arrival present in the facility was Licensee caring for 5 children (2 Infants, 1 Preschool, 1 school age). Facility hours of operation are: M-F from 07:00 AM to 06:00 PM. Capacity and ratio requirements were met on this day. All adults living and working in the home have criminal record clearances on file with Licensing Office. Licensee stated that no new residents moved into the home since licensure. A health and safety inspection was conducted in all areas accessible to children and the following was observed; Off-limits areas are: Entire upstairs. Licensee understand that children may never enter these off-limits areas. Home is clean and appropriately ventilated. LPA observed the required postings, a working telephone, 2A10BC fire extinguisher and functioning smoke and carbon monoxide detectors. A variety of toys and learning equipment available to the children. Licensee stated there are no weapons in the home. There are no bodies of water on the premises. Medications, toxic and hazardous items are inaccessible to children. Safety latches are in use on some kitchen cabinets, bathroom cabinets and drawers. The applicant understands that she must ensure the safety latches are not broken. The fireplace in the home is appropriately barricaded to prevent access by children. Outdoor play area is fenced for supervision and is free from defects or dangerous conditions. Licensee understands that 100 % supervision is required in unfenced outside areas Random sample of children’s files were reviewed. Family Child Care Home Notification of Parents’ Rights and required immunization records were on file. LPA observed a current children’s roster and proof of Fire and disaster drills that were properly log. The licensee and staff immunization are available in the facility file and CPR and First Aid certification was verified. Licensee CPR expires on 02/2021. AB 1207 Mandated Report Training was verified and expires 02/20. Licensee will renew training and will mail the new certificate to Licensing. Report continues on subsequent page 809C----

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020

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: WAHLSTROM, AISHA	FACILITY NUMBER: 343620826
	VISIT DATE: 02/18/2020

NARRATIVE

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This provider is currently not providing IMS services to children in care. 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.

LPA advised the licensee on Safe Sleep Practices and SIDS; She understand infants cannot sleep in car seats, swings or other items not intended for sleeping.

LPA also discussed the Smoking Probation Regulation (AB 1819-Smoking Prohibition), and the Nutritious Beverage Act.
Lead Poisoning Facts Information Flyer was provided and Licensee was advised that beginning January 1, 2019 a new law (AB 2370) requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. Safe Sleep in Child Care, and Quarterly Update Summer 2019 publications were provided.
Licensee was updated on immunization requirements from the Department of Public Health(CDHP) that will become effective July 1, 2019. Additional information and resources can be found on the https://www.shotsforschool.org website.

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 verified the annual fees are current. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so the licensee can request to be added to the distribution list to receive Quarterly Updates.

This facility evaluation report was reviewed and discussed with the licensee. A Notice of Site Visit was provided and should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at WWW.CDSS.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request. The licensee's signature on this form acknowledges receipt of this form.

>In the areas that were evaluated, no deficiencies were observed today under Title 22 Division 12 of the Ca. Code of Regulations.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020

LIC809 (FAS) - (06/04)

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