336300452-4-28-2023-10-CC-ANOE-CRBR6U-20230428124518

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 336300452
Report Date: 04/28/2023
Date Signed: 04/28/2023 12:45:25 PM

Document Has Been Signed on 04/28/2023 12:45 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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	ROMAN FAMILY CHILD CARE		FACILITY NUMBER:	336300452
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 0	DATE:	04/28/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:01 PM
MET WITH:	Mario Navarrete		TIME COMPLETED:	01:55 PM

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On date at 12:01 PM, Licensing Program Analyst (LPA) Ana Noble arrived at the facility to conduct a Case Management inspection due to the licensee applying for increase in capacity to a large family childcare home. Upon arrival, LPA met with Mario Navarrete, who stated that the licensee was not present and that there were no day-care children present. LPA Noble contacted Bertha Roman, Licensee via telephone call and Licensee indicated that she was closed however, Licensee stated that she would like inspection to be completed with Mr. Nazarrete, who is aware of were all records can be found. The home is single story home with 3 bedrooms, 2 bathrooms, with detached garage. Fire Clearance was approved by Riverside County Fire Dept.-Palm Desert on 4/11/2023. At 12:16 PM, LPA toured the facility, inside and out with Mr. Nazarrete and the following was observed and/or discussed:
· Normal days and hours of operation are: Monday-Friday 5:30 am - 11:00 pm

· Off-limit areas include: Masterbedroom/bath/bedroom 1, garage and kitchen.

· The facility is licensed to have no more 8 children as a Small FCCH and is operating within the licensed capacity and appropriate ratios.

· Appropriate supervision provided during this inspection

· A working telephone is present, and the current phone number is on file

· A fully charged fire extinguisher (2A:10BC) was observed. A smoke detector and carbon monoxide detector were present and tested by the Licensee during this inspection.

· All hazardous items are stored inaccessible to children

· Toxins are locked

· Weapons are not present according to Title 22. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

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
RIVERSIDE SOUTH EAST, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: ROMAN FAMILY CHILD CARE	FACILITY NUMBER: 336300452
	VISIT DATE: 04/28/2023

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· Single story home

· Clean, safe and age appropriate toys

· Current roster on file

· Facility Sketch, Emergency Disaster Plan and Notification of Parent’s Rights poster are posted

· Documentation of fire and disaster drills on file – Last drill conducted on 1/27/2023

· No bodies of water at this time.

· Verification of control of property on file

· Children’s records are complete

· Employee’s records are complete

· Mandated Reporter Training expired on 2/13/25

· Pediatric CPR and First Aid Card expire on 10/16/2023

· Health & Safety Certificate - completed on 11/4/2021

· Resident and/or staff records were reviewed and all adults who require caregiver background checks have received all required clearances and/or exemptions.

The licensee confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.
No deficiencies observed during time of inspection
Once all corrections have been made, with proof sent to licensing, the application for a Large Family Child Care Home will be submitted for approval with a maximum capacity of 12, or 14 with parent notification. As agreed upon by the licensee, all corrections are due within 30 days. If not received within 30 days from the date of this report, the application may be withdrawn, and the license will remain a Small Family Child Care Home.

Exit interview conducted and this report along with the appeal rights were reviewed and provided to facility representative, Mr. Mario Navarrete.

SUPERVISORS NAME: Deborah Mullen
LICENSING EVALUATOR NAME: Ana Noble
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2023

LIC809 (FAS) - (06/04)

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