<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617742
Report Date: 07/02/2021
Date Signed: 07/02/2021 02:21:34 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/02/2021 02:21 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:ROGERS, MARIAFACILITY NUMBER:
343617742
ADMINISTRATOR:ROGERS, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 608-8812
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 3DATE:
07/02/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Maria RogersTIME COMPLETED:
02:15 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
On Friday, July 2nd, 2021, Licensing Program Analyst (LPA) Kelly Ferrara conducted an unannounced annual inspection and met with Licensee Maria Rogers. LPA observed there were currently three children in care with the Licensee and an assistant. Facility hours of operation are Monday through Friday 7 AM- 4:30 PM. Licensee stated there are no new adult residents in the home, and all adults have a criminal record clearance. LPA observed proper ratio and capacity was being followed and annual fees have been paid.

Off limit areas include: Garage, bottom floor bedroom, left side yard, and entire upstairs. Licensee acknowledged that children may never enter these off-limit areas. LPA conducted a health and safety inspection and observed that the facility is clean, safe, sanitary, and in good repair with proper ventilation. LPA observed the proper documents were posted where visible to parents. LPA observed that there were no hazardous items accessible to children including cleaning compounds, medications, or sharp objects. LPA observed the stairs were barricaded and the fire extinguisher is in working condition and accessible. LPA observed the smoke and carbon monoxide detectors are functioning properly. The facility has adequate toys that are safe for children to use. Licensee stated there were no firearms in the home and LPA observed there were no bodies of water on the premises.

LPA reviewed safe sleep regulations for children under two in case Licensee decides to enroll infants. LPA observed the Licensee has a current CPR/First Aid certificate which expires 10/22. LPA observed the proper documents present for the assistant. LPA observed the facility children’s roster and fire drill log are current. LPA reviewed children’s files and observed that all the required documentation was present in each child's file.

Continued on 809-C

SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: ROGERS, MARIA
FACILITY NUMBER: 343617742
VISIT DATE: 07/02/2021
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
26
27
28
29
30
31
32
LPA discussed Incidental Medical Services- IMS. 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 current COVID guidelines with Licensee and provided technical assistance. LPA provided the Community Care Licensing’s website WWW.CCLD.CA.GOV, so the Licensee can obtain updated licensing information, new regulations and access forms. LPA advised Licensee of her responsibility to stay current by reviewing PINs on the website.

No Title 22 Deficiencies were observed in the areas that were evaluated. LPA reviewed report with the Licensee. LPA observed the Notice of Site Visit posted and the Licensee understands it must remain posted for 30 days.

SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2