<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620846
Report Date: 12/13/2019
Date Signed: 12/16/2019 11:36:12 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:HARRIS, SONYAFACILITY NUMBER:
343620846
ADMINISTRATOR:HARRIS, SONYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 640-7776
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:14CENSUS: 8DATE:
12/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Sonya Harris, LicenseeTIME COMPLETED:
02:20 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) Joleen Kenney met with the Licensee, Sonya Harris, for the purpose of an unannounced annual/random inspection. All individuals subject to criminal background review have obtained a criminal record clearance. Hours of operation for the facility are Monday-Friday, 7:00 AM to 7:00 PM. During today's inspection LPA observed 8 children supervised by the Licensee and Licensee's spouse.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas includes the entire upstairs, garage, backyard, laundry room and downstairs bedroom. Licensee acknowledged that children must never enter these areas. LPA observed the required postings, a working phone, fire extinguisher, and smoke and carbon monoxide detectors. Licensee stated there are no weapons in the home. Licensee understands children must have 100% supervision in unfenced areas. Toxic and hazardous items are inaccessible to children. The fireplace is appropriately barricaded to prevent access by children.

Children’s files were reviewed. LPA observed several missing documents from the children's files. LPA provided copies of all documents that are to be maintained in the children's files to the Licensee during today's inspection. LPA observed a current children's roster. Fire and disaster drills are being conducted and documented. The licensee's immunization records for measles (MMR), pertussis (Tdap), and the flu were discussed. Licensee has a in person EMSA CPR and First Aid certification that is currently expired. Licensee will schedule a training class to obtain a current CPR/First Aid certificate. Licensee and Licensee's spouse have completed the Mandated Reporter Training. The Licensee will complete the Mandated Reporter training to obtain an current certificate. Licensee understand that the training is required to be completed once every two years and the training is accessible at www.mandatedreporterca.com.

Report continues on 809-C.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Joleen KenneyTELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: HARRIS, SONYA
FACILITY NUMBER: 343620846
VISIT DATE: 12/13/2019
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
26
27
28
29
30
31
32
This Licensee does not currently provide 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.

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: https://www.ada.gov/childqanda.htm.

LPA verified that the annual fees are current. LPA provided and discussed the Safe Sleep in Child Care and Effects of Lead Exposure brochures.

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. The licensee's signature on this form acknowledges receipt of this form.



Two type B citations were cited on the following page of this report. Appeal rights were provided and an exit interview was conducted.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Joleen KenneyTELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: HARRIS, SONYA
FACILITY NUMBER: 343620846
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/13/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/13/2020
Section Cited

1
2
3
4
5
6
7
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:
8
9
10
11
12
13
14
LPA conducted file review of 4 children's files and observed children's files were incomplete.
This is a potential risk to the health and safety of children in care.
8
9
10
11
12
13
14
Type B
01/13/2020
Section Cited

1
2
3
4
5
6
7
The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid,
8
9
10
11
12
13
14
This requirement was not met as evidenced by: The LIcensee informed LPA Kenney that her CPR/First Aid certificate is expired.

This is a potential health and safety risk to children in care.
8
9
10
11
12
13
14
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) 263-5715
LICENSING EVALUATOR NAME: Joleen KenneyTELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:
DATE: 12/13/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/13/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3