390321204-2-19-2020-53-CC-CJAN-BLXV3P-20200219150502

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 390321204
Report Date: 02/19/2020
Date Signed: 02/19/2020 03:05:14 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:	MORTIMER, MICHELE		FACILITY NUMBER:	390321204
ADMINISTRATOR:	MORTIMER, MICHELE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 482-5523
CITY:	RIPON	STATE: CA	ZIP CODE:	95366
CAPACITY:	14	CENSUS: 2	DATE:	02/19/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Michele Mortimer		TIME COMPLETED:	03:15 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	Licensing Program Analyst (LPA) Christopher Jackson met with licensee Micehle Mortimer for an unannounced random annual inspection. LPA toured areas of the home accessible to children in care. Off-limit areas include Entire Upstairs, Backyard gated pool area and side yard. Licensee acknowledged that children may never enter these off-limit areas. The census included two children in care. Also present was licensee’s husband. Licensee stated there are no new residents in the home since licensure. All Adult residents have criminal record clearances. LPA observed current CPR/First Aid certificates which expire on 02/08/22. LPA discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed two of the children’s files in care. LPA observed fire drills were not conducted at least once every six months and six months. LPA observed the last documented drill to be conducted in June of 2019. LPA observed that there were no hazardous items accessible to children. LPA observed Fireplace which was screened. LPA observed that cleaning materials were not made inaccessible in the home. Licensee stated there are no weapons in the home. Fire extinguisher, smoke detector and carbon monoxide detector meet regulation. Toys appear to be safe. The backyard is fenced and gated. There is an in ground pool on the property which is completely surrounded by a see through mesh fence that is at least 5 feet high. LPA observed the gate to self-close and self-latch. There are no windows or doors that provide direct access into the pool area. LPA also observed an empty hot tub in the backyard. LPA observed the cover to be latched on all four sides during today's inspection. Report Continues on 809-C

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020

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: MORTIMER, MICHELE	FACILITY NUMBER: 390321204
	VISIT DATE: 02/19/2020

NARRATIVE

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LPA discussed the Mandated Reporter Training with licensee. LPA reminded the licensee of the requirement to renew the training every two years. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English.

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 recent changes in licensing requirements, including SB 277 (no longer accepting religious beliefs for immunization's) and SB 792 pertaining to immunization requirements for children and staff. Licensee provided proof of immunization's for the whooping cough, licensee was not able to provide proof of immunization against measles.

LPA checked facilities fees and confirmed that it is up to date.

LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws childcareadvocatesprogram@dss.ca.gov. LPA provided the pamphlet on "Effects of Lead Exposure", and the new CDPH 286 (updated immunization record). LPA also provided pamphlet on proposed safe sleep regulations.

Title 22 Deficiencies have been cited on the attached LIC 809D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 809D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 809D in each child's files
This report was reviewed and discussed with licensee. A notice of site visit and appeal rights were provided.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: MORTIMER, MICHELE	FACILITY NUMBER: 390321204
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/19/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 02/20/2020 Section Cited	1 2 3 4 5 6 7	Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger to children shall be stored where they are inaccessible to children.
	8 9 10 11 12 13 14	During today's inspection LPA observed various cleaning compounds around the houme. This poses an immediate health and saftey risk to children in care.	8 9 10 11 12 13 14
	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: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: MORTIMER, MICHELE	FACILITY NUMBER: 390321204
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/19/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/19/2020 Section Cited	1 2 3 4 5 6 7	Operation of a FCCH - All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. LPA observed the last fire drill to be conducted on June of 2019. This poses a potential health and safety risk to children in care.
Type B 03/19/2020 Section Cited	1 2 3 4 5 6 7	Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.
	8 9 10 11 12 13 14	During today's insepection LPA did not observe proof of immunization against mesales. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14
	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: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 02/19/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2020

LIC809 (FAS) - (06/04)

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