344500003-7-30-2021-53-CC-FDIZ-C5EPP6-20210730112900

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 344500003
Report Date: 07/30/2021
Date Signed: 07/30/2021 11:29:09 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:	OKOLO, CHIOMA		FACILITY NUMBER:	344500003
ADMINISTRATOR:	OKOLO, CHIOMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 627-1550
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95757
CAPACITY:	14	CENSUS: 1	DATE:	07/30/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Chioma Okolo		TIME COMPLETED:	11:45 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 Analyst (LPA) Fabiola Diaz met with Licensee Chioma Okolo on 7/30/2021 for the purpose of an unannounced annual random inspection. All individuals subject to criminal background review have obtained a criminal record clearance. Census at the time of inspection was 1 child. COVID-19 precautionary measures were implemented during this visit. Licensee explained her niece was visiting and was upstairs. A health and safety inspection was conducted in all areas accessible to children. On today's date licensee requested to make the backyard and kitchen off-limits. Off-limits areas include: all upstairs, garage, laundry room, formal living area, backyard, and kitchen. LPA observed the required postings and a working phone. LPA observed a working 2A10BC fire extinguisher, functioning smoke and carbon monoxide detectors. Licensee stated there are no weapons in the home. LPA observed a decorative two tier water fountain in the backyard. The bottom tier had standing water of 2.5 to 3.5 inches of depth. On today's date Licensee turned off the running water and emptied the water fountain. Licensee explained before she fills up the water fountain with water and turns it on, licensee will fill up the two tiers with rocks so there is not a puddle of standing water. LPA explained regulations of bodies of water. No hazardous items were accessible to children in care inside the home. Play toys and equipment were in safe conditions. LPA observed a fireplace to be barricaded according to Title 22. Licensee explained that parents drop-off children at the gate located between a storage closet and the laundry room, so children in care don't have access to the stairs upon entering the home. LPA observed today's child's file to be complete. LPA observed a current roster and discussed maintaining documentation that a fire drill is conducted at least once every six months. Licensee's immunization records for measles (MMR), pertussis (Tdap), and the flu were observed. Current in-person EMSA pediatric CPR and First Aid certification expires 5/23. LPA did not observe a current Child Care Provider Mandated Reporter certificate for licensee; LPA informed licensee the training shall be done every two years. A Technical Violation Note was assessed. Report continues on 809-C

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

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: OKOLO, CHIOMA	FACILITY NUMBER: 344500003
	VISIT DATE: 07/30/2021

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This provider is not currently providing 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: http://www.ada.gov/childqanda.htm.

LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so Licensee can request to be added to the distribution list to receive Quarterly Updates. LPA provided and discussed the Safe Sleep in Child Care PIN and regulations and Effects of Lead Exposure brochures. LPA discussed the requirements for adults who reside in the home and or assist with day care children.

This facility evaluation report was reviewed and discussed with 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. A copy of this report will remain on file for a period of three years for public review upon request. Licensee's signature on this form acknowledges receipt of this form.

The following Title 22 Deficiency is being cited on the subsequent 809-D pages. Upon receipt of Type A citations, licensee shall post and provide copies of the LIC 809-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Licensee must also keep the signed LIC 9224, acknowledging receipt of LIC 809-D in each child's file. Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit must remain posted for 30 days.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: OKOLO, CHIOMA	FACILITY NUMBER: 344500003
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/30/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/31/2021 Section Cited	1 2 3 4 5 6 7	102417Operation of a Family Child Care Home (g)The home shall be free... conditions which might endanger a child... precautions shall include...: (5) All licensees shall ensure the inaccessibility of...bodies of water...This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on obsevation and interview, the licensee did not ensure to make a decorative two tier water fountain in the backyard inaccessible to children in care.	8 9 10 11 12 13 14	Licensee stated she understands no bodies of water should be accessible to children on the premises at any point in time.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 263-2002
LICENSING EVALUATOR NAME: Fabiola Diaz	TELEPHONE: (916) 206-9352
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2021

LIC809 (FAS) - (06/04)

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