343623187-6-25-2021-03-CC-JKEY-C4BS2G-20210625132932

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623187
Report Date: 06/25/2021
Date Signed: 06/25/2021 01:29:42 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:	SISON, LEA MAE		FACILITY NUMBER:	343623187
ADMINISTRATOR:	SISON, LEA MAE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 420-2916
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95835
CAPACITY:	14	CENSUS: 9	DATE:	06/25/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Lea Mae Sison, Licensee		TIME COMPLETED:	01:40 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	At 12:35 a.m., Licensing Program Analyst (LPA) Joleen Kenney met with the Licensee, Lea Mae Sison, for the purpose of an annual inspection. All individuals subject to criminal background review have obtained a criminal record clearance. During today's inspection LPA observed 9 children supervised by the Licensee and Assistant. A health and safety inspection was conducted in all areas accessible to children. Off-limit areas includes entire upstairs, downstairs bedroom, laundry room and garage. Licensee acknowledged that children must never enter these off limit 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. At 12:45 a.m., a sample of children’s files were reviewed. LPA observed immunization records and signed Family Child Care Home Notification of Parents' Rights in children's files. LPA observed a current children's roster. Fire and disaster drills were discussed with the Licensee. The Licensee stated that she understands that the fire drills must be documented at least every six months. The licensee's and Assistant immunization records for measles (MMR), pertussis (Tdap), and the flu were verified. Licensee has an in person EMSA CPR and First Aid certification. The Licensee and Assistant are scheduled for a CPR and First Aid training class tomorrow 6/26/2021 to renew their certification. Licensee and Assistant have completed the Mandated Reporter Training. 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 Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Joleen Kenney	TELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

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: SISON, LEA MAE	FACILITY NUMBER: 343623187
	VISIT DATE: 06/25/2021

NARRATIVE

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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 notified the Licensee that the annual fees are due by 7/15/2021.

LPA discussed Safe Sleep Regulations with the Licensee. LPA reviewed Infant Individual Sleeping Plan (LIC9227) for children under 12 months of age and sleep logs for the children under two years of age.

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.

In the areas that were evaluated, no deficiencies were observed or cited during todays visit.

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Joleen Kenney	TELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:	DATE: 06/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2021

LIC809 (FAS) - (06/04)

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