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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343618440
Report Date: 07/21/2021
Date Signed: 07/21/2021 04:13:03 PM

Document Has Been Signed on 07/21/2021 04:13 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:RAOUAHI, AMELFACILITY NUMBER:
343618440
ADMINISTRATOR:RAOUAHI, AMELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 753-0560
CITY:SACRAMENTOSTATE: CAZIP CODE:
95826
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Amel RaouahiTIME COMPLETED:
04:20 PM
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Licensing Program Analyst (LPA) Gagandeep Singh met with licensee, Amel Raouahi, for an annual inspection. The purpose of the inspection was explained. Licensee lives in a single story home. There are no day care children present today. All adults living or working in the home have criminal background check on file. Licensee is operating within the capacity of this date.

LPA inspected the day care areas with the licensee. Day Care Areas:.Family room, Day care room, Kitchen, Hallway, Bedroom # 1, Bathroom and Backyard. Off limit areas: Garage, Master bedroom, Bedroom # 2 and Shed in the backyard. There is a pool in the backyard. LPA observed the pool has metal fence around with self latching gate in place. As per licensee, there is no firearm or weapon in the house. All the cleaning supplies, poisons and other chemicals are stored inaccessible to the children. Fireplace is barricaded with furniture. The house is in good repair and free of hazards with proper temperature and ventilation. There is carbon monoxide detector, smoke detector, fully charged fire extinguisher and working telephone available in the house. There is a variety of age appropriate toys in the house.

LPA reviewed the facility records. LPA observed licensee has License and other required documents posted in the child care areas. Licensee has record of training of preventive health and CPR card valid until June 13, 2023. LPA remind the licensee to conduct the fire or emergency drills at least once every six months and drills must be logged. Licensee has well maintained roster on file. LPA discussed the safe sleep regulations with the licensee and provided the copy of the PIN 20-24-CCP.

Licensee is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed licensee has completion certificate on file. See next page for continuation .......................
SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2021
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: RAOUAHI, AMEL
FACILITY NUMBER: 343618440
VISIT DATE: 07/21/2021
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LPA reminded the licensee that all adults, 18 years and older living in the home, helper or assistant must have criminal record clearance and must be associated to the facility by submitting an LIC 9182 with copy of CA DL or CA ID prior to having any contact with children in care. Failure to do so could result in an immediate civil penalty of $100.00 each day.

LPA encourage the licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC809 (FAS) - (06/04)
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