393608771-2-3-2020-53-CC-CJAN-BLFSDL-20200203124719

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393608771
Report Date: 02/03/2020
Date Signed: 02/03/2020 12:47:26 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:	FUNDERBURK, PATRICIA		FACILITY NUMBER:	393608771
ADMINISTRATOR:	FUNDERBURK, PATRICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 825-4486
CITY:	MANTECA	STATE: CA	ZIP CODE:	95337
CAPACITY:	14	CENSUS: 8	DATE:	02/03/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Patricia Funderburk		TIME COMPLETED:	12:55 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 Patricia Funderburk for an unannounced random annual inspection and toured areas of the home accessible to children in care. Off-limit areas include Entire second floor, garage, loft above garage, laundry room and side yard. Licensee acknowledged that children may never enter these off-limit areas. The census included eight children in care. Also present was licensee’s husband and adult daughter. 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 03/2020. LPA discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed three children’s files. LPA observed the children's files to be kept according to title 22 regulations. LPA observed fire drills were conducted at least once every six months and documented. LPA observed that there were no hazardous items accessible to children. LPA observed Fireplace which was screened. LPA observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. LPA observed a working fire extinguisher, smoke detector and carbon monoxide detector. There are no bodies of water observed. 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. 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: 02/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020

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: FUNDERBURK, PATRICIA	FACILITY NUMBER: 393608771
	VISIT DATE: 02/03/2020

NARRATIVE

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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 staff immunization's.

LPA discussed the new Mandated Reporter Training with licensee. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. In addition, existing licensees must meet requirements by March 30, 2018. 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. LPA observed the training completion certificate in staff files.

LPA checked facilities fees and confirmed that it is up to date. During today's inspection LPA provided copies of the new California immunization form, the lead exposure flyer and proposed changes in sleep regulation flyer to licensee.

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.

No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the licensee and provided copies. An exist interview was conducted. LPA observed the Notice of Site Visit posted and the licensee understands it must remain posted for 30 days.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 02/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2020

LIC809 (FAS) - (06/04)

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