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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343617742
Report Date: 02/05/2025
Date Signed: 02/05/2025 02:28:23 PM

Document Has Been Signed on 02/05/2025 02:28 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:ROGERS, MARIAFACILITY NUMBER:
343617742
ADMINISTRATOR/
DIRECTOR:		ROGERS, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 608-8812
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 14TOTAL ENROLLED CHILDREN: 7CENSUS: 5DATE:
02/05/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Maria RogersTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Kyrsten Williams conducted an unannounced case management inspection at the above facility. LPA met with licensee, Maria Rogers and the purpose of the inspection was explained. LPA observed five children in care being supervised by the licensee.

During inspection, it was learned licensee currently has an assistant, Carolina Tipula, employed at her facility. Based on record review, the assistant does not have a criminal record background clearance through Guardian system. LPA observed the assistant completed the application to obtain a criminal record background clearance in January 2023. As of April 2023, the application was closed due to unknown provider for the applicant to be associated to. Based on interview and record review, it was determined that the assistant has worked at the facility for more than five days. The licensee 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.

A deficiency is cited on the subsequent page of this report (LIC809-D) under the California Health and Safety Code. An immediate Civil Penalty of $500 has been assessed due to violation of the Health and Safety Code - Administration of Child Day Care Licensing 1596.871(c)(1)(A). The licensee was provided a copy of their Appeal Rights (LIC9058) and the licensee's signature on this form acknowledges receipt of these rights.

LPA Williams informed the licensee that upon receipt, licensee shall post and provide copies of this licensing report (dated 02/05/2025) to parents/guardians of children who are currently enrolled as well as parents/ guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must acknowledge receipt of this report and citation by signing a LIC 9224, “ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS”. A copy of this form should be placed in each child file upon receipt from parent.
Exit interview conducted and report was reviewed with the licensee, Maria Rogers. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Kyrsten Williams
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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Document Has Been Signed on 02/05/2025 02:28 PM - It Cannot Be Edited


Created By: Kyrsten Williams On 02/05/2025 at 01:56 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ROGERS, MARIA
FACILITY NUMBER: 343617742

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/06/2025
Section Cited
HSC
1596.871(c)(1)(A)

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Administration of Child Day Care Licensing 1596.871(c)(1)(A) Subsequent to initial licensure, a person ... shall obtain either a criminal record clearance or an exemption ... prior to employment, residence, or initial presence in the facility.
This requirement is not met as evidenced by:
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Licensee will not have the assistant return to the facility until the assistant completes fingerprints and obtains a criminal record clearance. LPA will return to the facility to observe all adults living or working in the home have obtained a criminal record clearance.
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Based on interview and record review, the licensee did not comply with the section cited above as the assistant has not obtained a criminal record clearance, which poses an immediate health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Seychelle De Luca
LICENSING EVALUATOR NAME:Kyrsten Williams
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2025


LIC809 (FAS) - (06/04)
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