393620451-7-7-2021-53-CC-CJAN-C4PSY5-20210707141659

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393620451
Report Date: 07/07/2021
Date Signed: 07/07/2021 02:17:06 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:	COLLIER, SANDY		FACILITY NUMBER:	393620451
ADMINISTRATOR:	COLLIER, SANDY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 333-7263
CITY:	MANTECA	STATE: CA	ZIP CODE:	95336
CAPACITY:	14	CENSUS: 11	DATE:	07/07/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Sandy Collier		TIME COMPLETED:	02:30 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 Sandy Collier for an unannounced random annual inspection. LPA toured areas of the home accessible to children in care. The off-limit areas are entire upstairs and garage. Licensee acknowledged that children may never enter these off-limit areas. The census included 10 children in care. Seven preschool age children and three children under the age of 24 months. Also present was licensee’s two assistants. 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 6/21/23. LPA discussed licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA observed a copy of the license, emergency disaster plan and Notification of Parents Rights posted in the home. LPA reviewed three children’s file and observed the files to be maintained 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 knives were kept in the pantry cabinet and inaccessible to children in care. LPA observed that cleaning materials were inaccessible and stored in a locked closet. Licensee stated there are no weapons in the home. LPA observed fire extinguisher, and a dual smoke and carbon monoxide detector in the home that 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 pool gate to open away form the body of water, self-close and self-latch. There are no windows or doors that provide direct access into the pool area. 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: 07/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021

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: COLLIER, SANDY	FACILITY NUMBER: 393620451
	VISIT DATE: 07/07/2021

NARRATIVE

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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 Guardian on-line system with licensee during today's inspection. LPA referred licensee to PIN 20-20 for reference. LPA discussed the infant safe sleep regulations with licensee. LPA discussed the 15 minute checks to be conducted with all infants 24 months and under during nap time. LPA explained the 15 minute checks need to be logged. LPA discussed the sleep plan to be completed with all infants 12 months and under. LPA provided a copy of the sleep plan to licensee for use with all infants enrolled in the home. LPA discussed the Mandated Reporter Training with licensee and discussed the two year renewal of the training. LPA provided the link for the training to the licensee at http://www.mandatedreporterca.com/.

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.

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: 07/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2021

LIC809 (FAS) - (06/04)

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