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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494782
Report Date: 10/21/2021
Date Signed: 10/21/2021 12:25:42 PM

Document Has Been Signed on 10/21/2021 12:25 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:RUCKS FAMILY CHILDCAREFACILITY NUMBER:
197494782
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
10/21/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Licensee Ashley Rukc'sTIME COMPLETED:
01:00 PM
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On October 21st 2021 an announced visit was made for the purpose of conducting an Inspection for increase in capacity. Licensing Program Analyst (LPA) Lisa Rios met with the licensee and toured the home inside and out inspecting all son the application sketch. There are 2 children residing in the home. With the increase in capacity, the licensee has included one bedroom into the license that will be used for nap time.

During the walk through of the facility LPA Rios found that the facility is clean, safe, sanitary, and in good repair. Inclines, stairways, ramps or open porches are inaccessible. Disinfectants/poisons and other hazardous items are inaccessible, they are kept locked in closets. There is an adequate food supply. Nutritious snacks are served between meals. The home has 2 working carbon monoxide detectors, 1 fire extinguisher 2-A10BC that were tested by the fire department on 8/10/21, complete 1st Aid kits, emergency supply bags, toys and play areas that are age appropriate. LPA observed napping equipment a single crib and a pack n play.

The licensee has also included a facility sketch for the back courtyard. The apartments all face in wards to a back courtyard that is privately gated. There is a grass area, cement area, picnic table with benches and shaded area for play. The licensee allows the older children to play back here supervised with a basketball and other outdoor activities. LPA Rios discussed with the licensee that when the children are outside that there should be a first aid kit, a way to talk to someone inside the home (cell phone or walkie talkie) and water available to the children.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Lisa Rios
LICENSING EVALUATOR SIGNATURE: DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/21/2021
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: RUCKS FAMILY CHILDCARE
FACILITY NUMBER: 197494782
VISIT DATE: 10/21/2021
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The Children's Personal Rights is posted, and the licensee has been instructed to report Personal Rights Violations.

There are no excluded persons on premises and all adults working in the home have Criminal Clearances.
Licensee has been reminded to report children injuries requiring medical treatment and other special incidents.

Criminal Record Statement Family Child Care Homes

Licensee [or facility representative] 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.


Incidental Medical Services (IMS) policy

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

Safe Sleep

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Lisa Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: RUCKS FAMILY CHILDCARE
FACILITY NUMBER: 197494782
VISIT DATE: 10/21/2021
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Notice of Site Visit

A notice of site visit was given and must remain posted for 30 days.

Exit Interview

The home is ready for licensure of 12 children. Exit interview conducted and report was reviewed with the licensee Ashley Rucks.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Lisa Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 10/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/21/2021
LIC809 (FAS) - (06/04)
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