073408808-8-31-2023-02-CC-CWAS-CV8NDU-20230831102252

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408808
Report Date: 08/31/2023
Date Signed: 08/31/2023 10:23:04 AM

Document Has Been Signed on 08/31/2023 10:23 AM - 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	ROCHE, SHARON & TORI		FACILITY NUMBER:	073408808
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 7	CENSUS: 6	DATE:	08/31/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Sharon & Tori Roche		TIME COMPLETED:	11:00 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	On 08/31/2023 at 8:50 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced case management – licensee initiated for Sharon and Tori Roche's small family child care home. LPA met with licensee and guided analyst on a tour of the facility. During today's inspection, there were 6 children in care (6 preschool aged children) and 7 children enrolled. Family members residing in the home are licensees. Licensees and all adults that care and supervise children have Criminal Record Clearance. Facility hours of operations are Monday - Thursday from 7:00 AM - 6:00 PM. Licensees completed their Pediatric CPR/First Aid certificate which expires 02/2024 and Mandated Reporter certificates which expires 01/2025. Licensees has documentation maintained for Measles, Pertussis Immunization's, and Influenza Opt-Out statement for the current flu season. Because the licensees rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the licensee confirms was provided to the property owner/landlord. The licensees obtained a signed Property Owner/Landlord Consent form (LIC 9149). There is a working telephone in the home. Fire clearance request was approved 08/08/2023 by the Contra Costa County Fire Protection Department. This is a one story home which consists of 2 bedrooms, 2 bathrooms, kitchen, dining room, living room and a backyard with an secured swing set, sandbox, play structure, trampoline, 5 picnic seating areas, big shipping container and a trailer. The shipping container and trailer is safely fenced and inaccessible to children in care. The children on limits areas: Living room, 2nd bedroom, 2nd bathroom, back yard with secured swing set, sandbox, play structure, trampoline, 5 picnic seating areas. Licensees will be utilizing the living room as the main room for the day care area. Areas off limits include: Master bedroom, kitchen, shipping container and trailer The LPA toured all areas used by children during this visit. *CON'T ON PAGE 2*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ROCHE, SHARON & TORI	FACILITY NUMBER: 073408808
	VISIT DATE: 08/31/2023

NARRATIVE

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*PAGE 2*

Per licensee, there are no firearms or weapons in the home. LPA observed a fully charged 2A10BC fire extinguisher, working dual smoke and carbon monoxide detector. Medicines, cleaning products, sharp objects are stored inaccessible to children. LPA reminded licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes. There are no stairs in the home. LPA observed 1 cat in the facility.

OUTDOOR SPACE: LPA inspected the backyard and observed the backyard is fully fenced and safe for children. LPA observed an anchored swing set, sandbox, play structure, trampoline, 5 picnic seating areas as well as age appropriate toys for children to play with. LPA did not observe any bodies of water. LPA observed a cat condo outside. Facility does not provide transportation for children, but licensees understands that children cannot be left alone, unattended in parked vehicles

LPA discussed and reminded licensees day care needs to be operated within the limitations and capacity of a Large Family Child Care Home with regards to ratios and that Licensees has to be present in the day care for 80% of the operation hours. The Licensees was reminded that an assistant is needed with a large family child care home license, and whenever an assistant is not present, the licensee will comply with the capacity requirements for a small family child care home. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Licensees was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

*CON'T ON PAGE 3*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ROCHE, SHARON & TORI	FACILITY NUMBER: 073408808
	VISIT DATE: 08/31/2023

NARRATIVE

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Licensees was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Effective as of 08/31/2023, increase of capacity application has been approved.

During today's inspection, there were no violation observed. Exit interview conducted and report was reviewed with the licensees, Sharon and Tori Roche. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

LIC809 (FAS) - (06/04)

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