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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
343622148
Report Date:
03/30/2023
Date Signed:
03/30/2023 04:05:06 PM
Document Has Been Signed on
03/30/2023 04:05 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
RIVER CITY (SACTO)CC
,
2525 NATOMAS PARK DR. STE.250
SACRAMENTO
,
CA
95833
FACILITY NAME:
DAVIS, KATIE
FACILITY NUMBER:
343622148
ADMINISTRATOR:
DAVIS, KATIE
FACILITY TYPE:
810
ADDRESS:
TELEPHONE:
(916) 425-5118
CITY:
SACRAMENTO
STATE:
CA
ZIP CODE:
95820
CAPACITY:
14
TOTAL ENROLLED CHILDREN:
4
CENSUS:
4
DATE:
03/30/2023
TYPE OF VISIT:
Required - 1 Year
UNANNOUNCED
TIME BEGAN:
12:45 PM
MET WITH:
Katie Davis
TIME COMPLETED:
02:20 PM
NARRATIVE
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On March 30, 2023 at 12:45 PM, Licensing Program Analyst (LPA) Tanya Washington and Licensing Program Manager Seychelle De Luca met with Licensee, Katie Davis for an unannounced required 1 year annual inspection and toured areas of the home accessible to children in care. During the inspection Licensee's two minor children and two daycare children were present in the home also present is Licensee's assistant Robin Patche. During today's inspection Licensee informed LPA that her off limits office was converted into her son's room and daycare children do enter the room and play there. Licensee requested to make her master bedroom off limits during the inspection. She stated that daycare children do not go into that room. The current off limit areas will be: Master bedroom and garage. The master bedroom is the last room in the hallway on the left. Licensee acknowledged that children may never enter these off-limit areas. Licensee stated there are no new residents in the home since licensure. All Adult residents have criminal record clearances. LPA discussed department policy on visitors and assistants. Licensee's hours of operation are Monday- Friday from 8 AM to 6 PM.
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
LPA observed current CPR/First Aid certificates for Licensee and Robin. LPA discussed recent changes in licensing requirements, including the posting of licensing inspection notices and reports and Parent Notification Requirements. LPA reviewed three children’s files. Licensee did not have a fire drill log available for review. Licensing staff did observe a children's roster.
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. Licensee stated that she currently does not have any children under the age of two enrolled.
REPORT CONTINUES ON NEXT PAGE.
SUPERVISORS NAME
:
Amanda Blesi
LICENSING EVALUATOR NAME
:
Tanya Washington
LICENSING EVALUATOR SIGNATURE
:
DATE:
03/30/2023
I acknowledge receipt of this form and understand my
licensing
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/30/2023
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
5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC
,
2525 NATOMAS PARK DR. STE.250
SACRAMENTO
,
CA
95833
FACILITY NAME:
DAVIS, KATIE
FACILITY NUMBER:
343622148
VISIT DATE:
03/30/2023
NARRATIVE
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During the tour of the home, Licensing staff observed the home to be cluttered. The carpets appeared heavily stained and the floors need to be vacuumed and deep cleaned. Licensee indicated that she is having her daycare room and the bathroom repainted and re-carpeted on April 14, 2023. During the tour of the backyard, LPA and LPM observed excessive amount of dirt and debris in the play area. Licensee stated she had her gutters cleaned out and hasn't had a chance to clean yet. Licensing staff observed items that must be kept out of reach in an exposed hallway closet, which is accessible to children. Licensing staff also observed cockroach spray on top of the kitchen refrigerator. Licensee was explained that all poisons must be locked and kept out of children's reach. Licensee stated there are no weapons in the home. Fire extinguisher, smoke detector and carbon monoxide detector meet regulation. There are no bodies of water on the premises.
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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:
http://www.ada.gov/childqanda.htm
.
Licensee's and Robin's Mandated Reporter training expired in 2021. The website to take the required training is
www.mandatedreporterca.com
. Licensee was reminded that the certification for herself and staff must be renewed every two years.
LPA advised licensee to sign up for the quarterly updates provided by the Childcare Advocates Program. LPA provided the link
https://www.cdss.ca.gov/inforesources/Community-Care-Licensing/subscribe
for the licensee to sign up for the updates.
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to
inspectionprocess@dss.ca.gov
. For additional information regarding the inspection and its tools and methods, please visit the
Program website
at
www.cd
ss.ca.gov/inforesources/community-care-licensing/process
.
Upon receipt, licensee shall post and provide copies of this licensing report 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. LPA reviewed this report with Licensee and provided a copy of appeal rights. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the
Facility Representative Katie Davis.
SUPERVISORS NAME
:
Amanda Blesi
LICENSING EVALUATOR NAME
:
Tanya Washington
LICENSING EVALUATOR SIGNATURE
:
DATE:
03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/30/2023
LIC809
(FAS) - (06/04)
Page:
2
of
5
Document Has Been Signed on
03/30/2023 04:05 PM
- It Cannot Be Edited
Created By:
Tanya Washington
On
03/30/2023
at
01:29 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
,
2525 NATOMAS PARK DR. STE.250
SACRAMENTO
,
CA
95833
FACILITY NAME:
DAVIS, KATIE
FACILITY NUMBER:
343622148
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
03/30/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. (A) Storage areas for poisons, firearms and other dangerous weapons shall be locked.
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 which poses an immediate health, safety or personal rights risk to persons in care. Licensing staff observed Raid bug killer on top of the kitchen refridgertaor. Poisons are required to be locked and stored in a area inaccessible to children. LPAs also observed items with a "keep out of reach" label in a hallway closet that did not have a door, the items were located at children's level.
POC Due Date:
04/03/2023
Plan of Correction
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2
3
4
Licensee will ensure to lock all poisons and will make all items that are potentially dangerous to children inaccessible. LPA will return to clear the citation.
Type A
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.
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 which poses an immediate health, safety or personal rights risk to persons in care. Licensee made the "office room" accessible to children. She stated that her son occupies the room and the daycare children play in that room.
POC Due Date:
04/03/2023
Plan of Correction
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2
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4
Licensee was informed that she must inform Licensing Office prior to making changes to on and off limit areas of her home. Licensee was also requested to submit an updated facility sketch.
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:
Tanya Washington
LICENSING EVALUATOR SIGNATURE:
DATE:
03/30/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/30/2023
LIC809
(FAS) - (06/04)
Page:
3
of
5
Document Has Been Signed on
03/30/2023 04:05 PM
- It Cannot Be Edited
Created By:
Tanya Washington
On
03/30/2023
at
01:29 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
,
2525 NATOMAS PARK DR. STE.250
SACRAMENTO
,
CA
95833
FACILITY NAME:
DAVIS, KATIE
FACILITY NUMBER:
343622148
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
03/30/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(b)
Operation of A Family Child Care Home
(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.
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 which poses a potential health, safety or personal rights risk to persons in care. Licensing staff observed that all rooms accessible to children are heavily cluttered and in need of deep cleaning.
POC Due Date:
05/01/2023
Plan of Correction
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2
3
4
Licensee stated she is in the process of cleaning out the rooms and will have the carpets replaced in the main daycare room. She stated that the walls will also be painted in the playroom and the bathroom. LPAs also observed the outdoor patio area needing deep cleaning. LPA will return to clear the citation.
Type B
Section Cited
CCR
102417(d)
Operation of A Family Child Care Home
(d) The home shall provide safe toys, play equipment and materials.
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 which poses a potential health, safety or personal rights risk to persons in care. Licensing staff observed a pile of broken toys that the children no longer use in the children's play area, Licensing staff also observed a children's size trampoline that did not have required pole padding.
POC Due Date:
05/01/2023
Plan of Correction
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Licensee will ensure that children are not using the trampoline until the padding for the poles arrives and is installed. Licensee will ensure that unused broken toys are removed from the children's play area by 5/1/2023. LPA will return to clear the citation.
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:
Tanya Washington
LICENSING EVALUATOR SIGNATURE:
DATE:
03/30/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/30/2023
LIC809
(FAS) - (06/04)
Page:
4
of
5
Document Has Been Signed on
03/30/2023 04:05 PM
- It Cannot Be Edited
Created By:
Tanya Washington
On
03/30/2023
at
01:29 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
,
2525 NATOMAS PARK DR. STE.250
SACRAMENTO
,
CA
95833
FACILITY NAME:
DAVIS, KATIE
FACILITY NUMBER:
343622148
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE:
03/30/2023
DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview with licensee, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Licensee stated she does not have a written fire drill log.
POC Due Date:
05/01/2023
Plan of Correction
1
2
3
4
LPA printed out a fire drill log and explained to licensee that she must conduct and record a fire drill at least once every six months.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.
This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care. Licensee and her assistant Robin did not have proof of required Mandated Reporter training.
POC Due Date:
05/08/2023
Plan of Correction
1
2
3
4
Licensee and her assistant will ensure to take the required training by POC date of 05/08/2023. Proof of training can be e-mailed to LPA Washington tanya.washington@dss.ca.gov
The website for the training is www.mandatedreporterca.com
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:
Tanya Washington
LICENSING EVALUATOR SIGNATURE:
DATE:
03/30/2023
I acknowledge receipt of this form and understand my
appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
03/30/2023
LIC809
(FAS) - (06/04)
Page:
5
of
5