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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343621511
Report Date: 11/14/2024
Date Signed: 11/14/2024 02:06:27 PM

Document Has Been Signed on 11/14/2024 02:06 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:ROJAS, ELIZABETH & JOSEPHFACILITY NUMBER:
343621511
ADMINISTRATOR/
DIRECTOR:		ROJAS, ELIZABETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 349-6077
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
11/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:15 PM
MET WITH:Joseph & Elizabeth RojasTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On Thursday, 14 November, 2024, at approximately 12:15 pm, Licensing Program Analysts (LPA) Fabian Schwartz and Josiah Gathing met with Licensees, Elizabeth and Joseph Rojas, for the purpose of an unannounced annual inspection. Upon arrival, LPAs observed licensee supervising 6 children, 3 of which are infants. All individuals subject to criminal background review have obtained a criminal record clearance. LPAs observed proper ratio and capacity was being followed. Facility hours of operation are Monday-Friday 6:00am-12:00am. LPAs verified that the annual fees are not current with an outstanding balance of $770. Licensees stated they paid fees during LPAs visit.

A health and safety evaluation was conducted in all areas accessible to children. Facility is a 3 bedroom, 3 bathroom two-story home. Off-limit areas include: Upstairs, Garage, Laundry Room, and Back patio. Licensee acknowledged that children may never enter these off-limit areas. LPA observed that the facility is clean, sanitary, and in good repair. LPAs observed a functioning smoke detector and a full at least size 2A10BC fire extinguisher. LPAs observed a carbon monoxide detector at facility, but it was not functional. The facility has adequate toys that appear to be safe for children to use. LPAs observed a saucer chair at facility which are not allowed in child care facilities. The licensee stated there are no weapons or poisons in the home.

LPAs reviewed 6 children’s files which were observed to be mostly complete. 3 out of 6 files were missing vaccination information for children in care. Required postings were seen in front hallway of facility, and the children’s roster was observed. LPAs observed infant sleep plan (LIC 9227) but did not observe 15-minute observation checks for napping infants. The facility has record of conducting fire drills at least every 6 months with the last fire drill being conducted on 2 October 24. Both of Licensee’s CPR/First Aid card expire on 25 November 25. Licensee Joseph’s Mandated Reporter certificate expires on 26 June 26, and Licensee Elizabeth’s Mandated Reporter Certificate expires on 29 November 25. Licensees understands that trainings must be completed every two years. PAGE 1. REPORT CONTINUES ON LIC809-C
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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: ROJAS, ELIZABETH & JOSEPH
FACILITY NUMBER: 343621511
VISIT DATE: 11/14/2024
NARRATIVE
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Licensee 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.

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

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.

PAGE 2. REPORT CONTINUES ON LIC809-C
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
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: ROJAS, ELIZABETH & JOSEPH
FACILITY NUMBER: 343621511
VISIT DATE: 11/14/2024
NARRATIVE
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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.

A notice of site visit was given and must remain posted for 30 days. Based on the inspection, 1 Type A and 3 Type B Title 22 citations have been issued. Type A citation is for not having a functioning carbon monoxide detector and Type B citations are for not having children’s vaccinations in files, having a banned saucer chair at facility, and not maintaining infant sleep logs for children under 2 years old. Citations explained further on accompanying LIC-809-D pages.

Title 22 deficiencies are cited on the subsequent pages of this report. Licensees acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809-D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the Licensee. LIC 9224 and Appeal Rights were provided. Licensees’ signature on this report acknowledges receipt of these rights.

Exit interview conducted and report was reviewed with the licensee. During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 11/14/2024 02:06 PM - It Cannot Be Edited


Created By: Fabian Schwartz On 11/14/2024 at 01:31 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: ROJAS, ELIZABETH & JOSEPH
FACILITY NUMBER: 343621511

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above by not having a working carbon monoxide detector present at facility which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/15/2024
Plan of Correction
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Licensees will acquire carbon monoxide and have it present at facility and email LPA proof by 15 November 24.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Amanda Blesi
LICENSING EVALUATOR NAME:Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:
DATE: 11/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/14/2024


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/14/2024 02:06 PM - It Cannot Be Edited


Created By: Fabian Schwartz On 11/14/2024 at 01:31 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: ROJAS, ELIZABETH & JOSEPH
FACILITY NUMBER: 343621511

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(d)(1)
Operation of A Family Child Care Home
(d) The home shall provide safe toys, play equipment and materials. (1) Fixtures, furniture, and equipment that have been banned or recalled by the United States Consumer Product Safety Commission shall not be used for children in care or accessible to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensees did not comply with the section cited above by having a saucer chair present at facility, which is not an allowed item in Family Child Care Homes which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/14/2024
Plan of Correction
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Licensees will remove saucer chair from facility and email LPA proof of its removal by 14 December 24.
Type B
Section Cited
CCR
102418(g)
Immunizations
(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above by having 3 out of 6 children's files missing vaccination documentation which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/14/2024
Plan of Correction
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Licensees will obtain vaccination documentation for all children in care and email LPA proof of childrens documents by 14 December 24.
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:Amanda Blesi
LICENSING EVALUATOR NAME:Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:
DATE: 11/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/14/2024


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 11/14/2024 02:06 PM - It Cannot Be Edited


Created By: Fabian Schwartz On 11/14/2024 at 01:31 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: ROJAS, ELIZABETH & JOSEPH
FACILITY NUMBER: 343621511

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above by not maintaining sleep logs for children under 2 years old which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/14/2024
Plan of Correction
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Licensees will maintain sleep logs for infants in care and will email LPA 2 weeks worth of completed infant sleep logs by 14 December 24.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Amanda Blesi
LICENSING EVALUATOR NAME:Fabian Schwartz
LICENSING EVALUATOR SIGNATURE:
DATE: 11/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/14/2024


LIC809 (FAS) - (06/04)
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