343623232-9-5-2019-03-CC-ASIA-BFQN68-20190905101045

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623232
Report Date: 09/05/2019
Date Signed: 09/05/2019 10:10:50 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:	PARKER, PRASKOVIIA		FACILITY NUMBER:	343623232
ADMINISTRATOR:	PARKER, PRASKOVIIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(219) 945-7777
CITY:	FAIR OAKS	STATE: CA	ZIP CODE:	95628
CAPACITY:	14	CENSUS: 0	DATE:	09/05/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Praskoviia Parker		TIME 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 Analysts (LPAs) Amy Silva and Seychelle De Luca met with applicant, Praskoviia Parker, for the purpose of an announced pre-licensing inspection. Also present was assistant. Applicant and assistant have obtained a criminal record clearance. Applicant's days and hours of operation are Monday through Friday 7:00 AM to 6:00 PM. A health and safety inspection was conducted inside and out. The single story home has an unfenced front yard, master bedroom, bedroom, two bathrooms, a living room, kitchen. There is also a shed, a green house, and a storage building located on the property. The off-limit areas in the home are the master bedroom, master bathroom,shed, a green house, and a storage building . Off-limits areas will remain inaccessible to children by closed doors and/or supervision. The applicant acknowledges that she must contact licensing prior to making an off-limits area on-limits and vice versa. Toxic and hazardous items are inaccessible to children. Functioning smoke and carbon monoxide detectors and a 2A10BC fire extinguisher were observed in the home. Preventative Health, current pediatric CPR and first aid training was verified and expires 3/6/2021. Mandated Reporter training was verified and expires 8/12/2021. Applicant stated there are no weapons in the home. In the areas that were inspected today, LPAs did not observe any bodies of water. Applicant was encouraged to maintain supervision at all times. Type A/B citations and Immediate Civil Penalty regulation deficiencies were reviewed. Report continues on 809-C.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019

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: PARKER, PRASKOVIIA	FACILITY NUMBER: 343623232
	VISIT DATE: 09/05/2019

NARRATIVE

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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

This facility evaluation report was reviewed and discussed with the applicant. LIC 311D, records, postings, and reporting requirements were discussed. LPAs discussed supervision, personal rights, criminal record clearances, staffing ratios and capacity, and maintaining buildings and grounds. Applicant was encouraged to visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to family child care homes. LPAs provided and discussed the Safe Sleep in Child Care brochure.

This home will be recommended for a Large Family Child Care License to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or above and 1 child at least age 6 with a maximum of 3 infants, pending the following items:

-Assistant's husband will obtain a criminal record clearance.
-Applicant will send LPA Silva assistant's husband's LIC 508 and TB test.
-Applicant will send LPA Silva an updated rental agreement.
-LPM Keven Peters' final file review.
-LPA Silva will return after LPM's review.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2019

LIC809 (FAS) - (06/04)

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