364842743-6-1-2023-09-CC-JGIE-CSDUED-20230601153057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364842743
Report Date: 06/01/2023
Date Signed: 06/01/2023 03:31:16 PM

Document Has Been Signed on 06/01/2023 03:31 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	ROUTHIEAUX FAMILY CHILD CARE		FACILITY NUMBER:	364842743
ADMINISTRATOR:	ROUTHIEAUX, HEIDI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 862-6410
CITY:	HIGHLAND	STATE: CA	ZIP CODE:	92346
CAPACITY:	14	CENSUS: 7	DATE:	06/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Heidi Routhieaux		TIME COMPLETED:	03:45 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	On date and time listed above, Licensing Program Analyst (LPA) Justin Giese arrived at the facility to conduct a 1 year required annual inspection. LPA was granted entry by LIcensee, Heidi Routhieaux. LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: This is a Large Family Child Care Home, LPA observed 7 children in care. Normal days and hours of operation are: Monday - Friday, 7:00 am to 5:15 pm OFF-LIMIT AREAS INCLUDE: All bedrooms, Garage, Laundry Room A review of the staff records and review of a sampling of children's records were conducted as part of this evaluation. The inspection consisted of reviews of the following domains: • Physical Plant • Care and Supervision • Facility Administration • Records • Staffing Ratio and Capacity • Personal Rights Facility was found to be in compliance in these domains, except where noted on LIC809D

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ROUTHIEAUX FAMILY CHILD CARE	FACILITY NUMBER: 364842743
	VISIT DATE: 06/01/2023

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

· The facility is operating within the licensed capacity and appropriate ratios
· The Licensee is present in the home and has ensured that children in care are supervised at this time
· When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children
· A working telephone is present
· Appropriate fire extinguisher, smoke detector and carbon monoxide detector is present and were tested during this inspection.
· All hazardous items are inaccessible, this includes: detergents, cleaning compounds, medications and other items which could pose a danger to children
· Storage of poisons is inaccessible to children and locked
· There is a properly barricaded fire place
· No weapons or firearms are stored at the facility as stated by Licensee: Licensee understands all guns, weapons and ammunition must be key-locked separately and made inaccessible per Title 22 regulations
· Home is clean and orderly, with heating and ventilation for safety and comfort
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced or appropriate supervision is present
· Verification of control of property on file
· Property owner/landlord notification and consent on file
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted
· Pediatric CPR and First Aid Card have expired 03/10/2020 (See LIC809D)
· Health & Safety Certificate completed on 05/04/2014
· There are no bodies of water, at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC809 (FAS) - (06/04)

Page: 2 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ROUTHIEAUX FAMILY CHILD CARE	FACILITY NUMBER: 364842743
	VISIT DATE: 06/01/2023

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

·Documentation of fire drills are to be conducted every six months: last drill was 01/17/2023
· Each child’s file reviewed contained a copy of the emergency information card with required information

Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed. All individuals subject to a criminal record review shall obtain a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. This was verified on 06/01/2023
Reminders:
- Current facility’s phone numbers must be on file at all times.
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills are to be conducted every six months
- Responsibilities of being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The licensee is urged to visit the U.S. Consumer Product Safety Commission webpage at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled.
- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.
- Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov.
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care

- Please subscribe to childcareadvocatesprogram@dss.ca.gov to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov

- The Duty Officer is available to answer questions Monday – Friday 951-782-4200

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC809 (FAS) - (06/04)

Page: 3 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ROUTHIEAUX FAMILY CHILD CARE	FACILITY NUMBER: 364842743
	VISIT DATE: 06/01/2023

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

The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox:

UnusualIncidentReportsDO09@dss.ca.gov

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 discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC809 (FAS) - (06/04)

Page: 4 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ROUTHIEAUX FAMILY CHILD CARE	FACILITY NUMBER: 364842743
	VISIT DATE: 06/01/2023

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

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience.

If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov

For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process

A notice of site visit was given:

THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS

Exit interview conducted and report was reviewed with the Licensee, Heidi Routhieaux

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC809 (FAS) - (06/04)

Page: 5 of 6

Document Has Been Signed on 06/01/2023 03:31 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: ROUTHIEAUX FAMILY CHILD CARE	FACILITY NUMBER: 364842743
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above. Mandated Reporter Certificate on file was expired and needs renewal. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/01/2023
	Plan of Correction
1 2 3 4	Licensee understands the importance of this regulation and stated they will complete/renew Mandated Reporter "general" and "child care providers" training and submit to LPA on or before the stated POC date of 07/01/2023. Licensee can submit via email: justin.giese@dss.ca.gov

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above. EMSA approved CPR certification on file was expired and needs renewal. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/01/2023
	Plan of Correction
1 2 3 4	Licensee understands the importance of this regulation and stated they will complete/renew EMSA/Red Cross/Heart association approved CPR certification and submit to LPA on or before the stated POC date of 07/01/2023. Licensee can submit via email: justin.giese@dss.ca.gov

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: Gilbert Sena	TELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Justin Giese	TELEPHONE: (951) 204-4847
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC809 (FAS) - (06/04)

Page: 6 of 6