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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619162
Report Date: 07/21/2021
Date Signed: 07/21/2021 11:05:28 AM

Document Has Been Signed on 07/21/2021 11:05 AM - 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:SPARKS-FOURNIER, SUSAN & FOURNIER, MICHAELFACILITY NUMBER:
343619162
ADMINISTRATOR:SPARKS-FOURNIER, SUSANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 363-5437
CITY:SACRAMENTOSTATE: CAZIP CODE:
95826
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 10DATE:
07/21/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Susan & Michael FournierTIME COMPLETED:
11:10 AM
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Licensing Program Analyst (LPA) Singh met with both of the licensees, Susan & Michael Fournier, for an annual inspection. The purpose of the inspection was explained. Licensees lives in a single story home. Present, there are ten children ( 1 infants, six pre school age, 3 school age) in care with both of licensees and three helpers. 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: Living room, Kitchen, Hallway, Play room, Bathroom and Backyard. Off limit areas: Master bedroom, Garage. 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. Cabinets in kitchen and bathroom have child protective locks installed. Fireplace has metal screen protector 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. There is a water pond in the backyard.

LPA reviewed the facility records. LPA observed licensee has License and other required documents posted in the child care areas. LPA observed licensee has COVID-19 precautionary posters posted and visible from outside the door. LPA observed temperature get checked on the children, before entering the facility. Licensee has record of completing training of preventive health and CPR card in July 2021. The helpers also has valid CPR training certificates on file. 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 July 06, 2021. 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. LPA discussed the safe sleep regulation and provided a copy of PIN 20-24-CCP.
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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)
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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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: SPARKS-FOURNIER, SUSAN & FOURNIER, MICHAEL
FACILITY NUMBER: 343619162
VISIT DATE: 07/21/2021
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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 and all helpers has completed the training and certificates are on file.

Licensee is aware 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, Susan Sparks-Fournier. 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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