343618440-7-10-2023-03-CC-GSIH-CTLVX8-20230710164908

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343618440
Report Date: 07/10/2023
Date Signed: 07/10/2023 04:49:28 PM

Document Has Been Signed on 07/10/2023 04:49 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:	RAOUAHI, AMEL		FACILITY NUMBER:	343618440
ADMINISTRATOR:	RAOUAHI, AMEL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 753-0560
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95826
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 11	DATE:	07/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Amel Raouahi		TIME COMPLETED:	03:20 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	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. Present, there are 11 children in care with licensee. All adults living or working in the home have criminal background check on file. Licensee provides day care from Monday to Friday between 7 AM to 6 PM. 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. 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. 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. Licensee has sufficient amount of cribs 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 2023. LPA observed licensee has completion certificate for Mandated reporter training. Per certificate, the training is valid until July 01, 2024. LPA remind the licensee to conduct the fire or emergency drills at least once every six months and drills must be logged. Licensee has a log in place and per log, last drill was conducted on June 22, 2023. LPA also reviewed the present children's record. LPA reviewed the identification and emergency information form for every child for proper names and numbers filled. Licensee has record of immunization of each child in care. See next page for continuation ....................

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: RAOUAHI, AMEL	FACILITY NUMBER: 343618440
	VISIT DATE: 07/10/2023

NARRATIVE

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Continuation from page one ................
Facility representative 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.

LPA discussed with facility representative the safe sleep regulations and the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed L1 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Facility representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California. To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
See next page for continuation .............

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: RAOUAHI, AMEL	FACILITY NUMBER: 343618440
	VISIT DATE: 07/10/2023

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	Continuation from page two ........ Exit interview conducted and report was reviewed with the facility representative. See next page for citations issued today. During the exit interview, facility represenative confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 07/10/2023 04:49 PM - It Cannot Be Edited

Created By: Gagandeep Singh On 07/10/2023 at 02:37 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: RAOUAHI, AMEL	FACILITY NUMBER: 343618440
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(e)

Staffing Ratio and Capacity

(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above as LPA observed licensee supervising the eleven children by herself, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 07/11/2023
	Plan of Correction
1 2 3 4	During the inspection, licensee had a helper arrived and helped the licensee supervise the children.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Natalie Dunaway

LICENSING EVALUATOR NAME:

Gagandeep Singh

LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2023

LIC809 (FAS) - (06/04)

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