343623008-3-13-2020-03-CC-CBEO-BMNN2U-20200313100520

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623008
Report Date: 03/13/2020
Date Signed: 03/13/2020 10:05:32 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:	GRAY, LATONIA		FACILITY NUMBER:	343623008
ADMINISTRATOR:	GRAY, LATONIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 503-3644
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95828
CAPACITY:	14	CENSUS: 5	DATE:	03/13/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:35 PM
MET WITH:	Latonia Gray		TIME COMPLETED:	10:15 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 Analysts (LPAs) Christopher Bello and Mai Lor met with licensee Latonia Gray for an unannounced random annual inspection and toured areas of the home accessible to children in care. Off-limit areas the two front bedrooms connected to the Jack and Jill bathroom, master bedroom and backyard. Licensee acknowledged that children may never enter these off-limit areas. The census included five children. Also present was licensee’s husband and minor child. Licensee stated there are no new residents in the home since licensure. All Adult residents have criminal record clearances. LPAs observed current CPR/First Aid certificates which expire on 3/2020. LPAs discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPAs reviewed some children’s files. LPAs observed fire drills were conducted at least once every six months and documented. LPAs notified licensee of upcoming safe sleep and lead testing regulations. LPAs observed that there were no hazardous items accessible to children. LPAs observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Fire extinguisher, smoke detector and carbon monoxide detector meet regulation. Toys appear to be safe. The backyard is fenced and gated. There are no bodies of water observed. LPAs consulted the licensee regarding the Covet 19 virus. 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. REPORT CONTINUES ON NEXT PAGE

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher Bello	TELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020

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: GRAY, LATONIA	FACILITY NUMBER: 343623008
	VISIT DATE: 03/13/2020

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

LPAs observed current Mandated Reporter Training in file.
LPAs checked facilities fees and confirmed that it is up to date.
LPAs provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPAs advised licensee of their responsibility to stay current in regards to new regulations.

LPAs advised licensee to sign up for the quarterly updates provided by the Childcare Advocates Program. LPA sprovided the link https://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe for the licensee to sign up for the updates.

No Title 22 Deficiencies observed in the areas that were evaluated. LPAs reviewed report with the director and provided copies. An exit interview was conducted. LPAs observed the Notice of Site Visit posted and the director understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher Bello	TELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:	DATE: 03/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2