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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621511
Report Date: 03/24/2022
Date Signed: 03/24/2022 01:56:24 PM


Document Has Been Signed on 03/24/2022 01:56 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:ROJAS, ELIZABETH & JOSEPHFACILITY NUMBER:
343621511
ADMINISTRATOR:ROJAS, ELIZABETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 349-6077
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY:14CENSUS: 6DATE:
03/24/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Joseph & Elizabeth RojasTIME COMPLETED:
10:30 AM
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) Michelle Pascual met with licensee Joseph & Elizabeth Rojas for an annual/random inspection. LPA toured areas of the home accessible to the children. Off-limit areas are: entire upstairs, garage & laundry room. Licensee acknowledged that children may never enter these off-limit areas. Licensee stated there are no new residents in the home, and all adult residents have criminal record clearances. Upon arrival today’s census were six children present.

LPA observed current CPR/First Aid certificate (exp: 10/23) and Mandatory Reporter training will be renewed ASAP. Posted License, Parents' Rights Poster, facility sketches, and Emergency Disaster Plan. LPA discussed recent changes in licensing requirements, including SB 277 and SB 792 pertaining to immunization requirements for children and staff, also discussed today was AB1207 Mandated Reporter training. LPA reviewed children's records and client roster.

LPA observed hazardous items (detergents, cleaning compounds, medication, sharp utensils, andher items that could pose a danger to children in care). properly stored out of children's reach. Stairs were properly barricaded. There is a working telephone in the home.
Licensee stated there are no weapons in the home. Fire extinguisher, carbon monoxide and smoke detector meet regulation. LPA observed fire drills documented on a calendar. Toys appear to be safe and in working order.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2022
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 2


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: ROJAS, ELIZABETH & JOSEPH
FACILITY NUMBER: 343621511
VISIT DATE: 03/24/2022
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 provider is not currently 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 discussed infant sleep regulations with Licensee and observed all infant sleep logs.

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.

LPA reviewed and discussed this facility evaluation report with the Licensee. LPA provided a Notice of Site Visit and the Licensee acknowledges that this notice should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at http://ccld.ca.gov for child care updates, current forms, legislation and regulation information.



Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiencies are cited during today's inspection.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2