343622774-10-6-2021-53-CC-MPRE-C7JSFB-20211006135003

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343622774
Report Date: 10/06/2021
Date Signed: 10/06/2021 01:50:26 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:	SILVA, ERIKA		FACILITY NUMBER:	343622774
ADMINISTRATOR:	SILVA, ERIKA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 366-8571
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	14	CENSUS: 9	DATE:	10/06/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:27 AM
MET WITH:	Erika Silva		TIME COMPLETED:	01:48 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	On 10/6/2021 at 11:27am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Erika Silva for an Unannounced Annual Inspection. Present during the inspection was the Licensee, her fingerprint cleared husband G. Vega, daughter M. Zeas, two (2) infants and seven (7) preschool children. Licensee lives in the home with her two daughters and husband. Licensee’s home was toured for a health and safety inspection. The facility operates from 7:00am – 5:30pm. ON LIMITS AREA: Living Room, Office, Kitchen, , Bedroom Downstairs, Formal Dining Room, Daily Dining Room and Backyard OFF LIMITS AREA: Entire 2^nd Floor, Bathroom next to Bedroom downstairs and Garage ISOLATION AREA: Downstairs Bedroom The facility is a two-story home owned by the Licensee. The inside and outside of the home are observed to be neat and clean with ample age appropriate materials for the children. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. The home has one (1) fully charged 2A10BC fire extinguisher in the office. There is one (1) working smoke detector in the living room and the office. There is a pull-down fire alarm in the hallway as well. The working carbon monoxide detector is located in the hallway. The home is equipped with central heating and air for proper ventilation. The fireplace in the living room has been blocked by furniture and made inaccessible to the children in care. Licensee has stated that there is one (1) dog and no firearms in the home. The play structure in the backyard is sturdy and poses no threat to the children’s safety. There is a fountain outside that has a gate around it and a pool that has a gate 5ft high, self-locking, and a door that swings away from the pool. All bodies of water around the home has been made inaccessible to the children in care. Continued on LIC809-C

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 340-6032
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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: SILVA, ERIKA	FACILITY NUMBER: 343622774
	VISIT DATE: 10/06/2021

NARRATIVE

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The Licensee’s Health and Safety training has been completed. Pediatric CPR & First Aid training has been completed and expires on 3/7/2022. Mandated Reporter training has been completed and expires on 7/5/2023. All required forms are posted and visible for public view by the front door. LPA obtained the children’s files and her helper’s files. All files are complete. LPA obtained the fire/disaster drill log. Log is complete with last drill logged 7/6/2021.

Licensee was reminded that California Law requires licensees to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov. Licensee was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting http://www.mandatedreporterca.com.

Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Children’s Roster must be properly maintained, and fire/disaster drill must be conducted every six (6) months and documented. The licensee is reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

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

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
Continued on LIC809-C

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 340-6032
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

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: SILVA, ERIKA	FACILITY NUMBER: 343622774
	VISIT DATE: 10/06/2021

NARRATIVE

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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Erika Silva.

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) 926-9269
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 340-6032
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021

LIC809 (FAS) - (06/04)

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