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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623730
Report Date: 12/14/2021
Date Signed: 12/14/2021 04:12:20 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:STRICK,RACHAELFACILITY NUMBER:
343623730
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
12/14/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Rachel StrickTIME COMPLETED:
10:20 AM
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On 12/14/21 at 8:45AM, a required annual inspection was made to the facility by Licensing Program Analyst (LPA), Mikah Martinez. A review of staff records on 12/13/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently 2 adults living in the home. At 9:12AM the home was toured inside and outside. The licensee was supervising 6 children, and operating within the licensed capacity and ratio requirements. The facility’s operating hours are 7-5:30PM, Tuesday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are the upstairs with the exception of the napping room, the downstairs kitchen and garage, and were made inaccessible by gate. Poisons are locked in the garage. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. There is a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The licensee stated there are no firearms and/or other dangerous weapons in the home, and none were observed during today's inspection. The home is clean, orderly and comfortable. Stairs are barricaded with a baby gate. There are safe toys and equipment available for children. There is a working telephone in the home. There are cribs/play yards available for napping infants. Cribs have firm mattresses and are free of loose objects. Bedding is laundered weekly, and soiled bedding is stored inaccessible to infants. Napping infants are checked on every 15 minutes, and checks are documented on a written document. No infants were observed to be swaddled, and infants under 12 months are placed on their backs for sleeping. The children use the back yard as the outdoor play area and it is fully fenced. There were no pools or other bodies of water observed in the yard. Six children's records were reviewed at 9:40AM ; required emergency information forms were observed to be on file. Individual Sleeping Plans were on file for infants under 12 months of age. The licensee has completed Mandated Reporter training. The licensee and all employees have the required immunization's on file. The licensee has current pediatric CPR and First Aid certification, which expire on 2/1/22. This report was reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years.
Notice of Site Visit shall be posted for 30 days from today's visit.
There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (916) 862-1086
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021
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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