343622164-1-27-2025-03-CC-SMAX-DDBR74-20250127114543

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343622164
Report Date: 01/27/2025
Date Signed: 01/27/2025 11:45:53 AM

Document Has Been Signed on 01/27/2025 11:45 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	MATTE, SARA		FACILITY NUMBER:	343622164
ADMINISTRATOR/ DIRECTOR:	MATTE, SARA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 337-8283
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 10	DATE:	01/27/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:30 AM
MET WITH:	Sara Matte		TIME VISIT/ INSPECTION COMPLETED:	12:00 PM

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On 01/27/2025, Licensing Program Analyst (LPA) Soleil Marx met with Licensee, Sara Matte, for an unannounced annual inspection. During the inspection there was a census of ten children in care being supervised by the licensee and assistant. Ages of children were verified during file review to ensure ratio/capacity were adhered to. Facilities hours of operation are Monday through Friday 07:30 AM to 05:30 PM.

Off limit areas include: Garage, upstairs, rental cottage, and side yard. Licensee understands that children may never enter off-limit areas. LPA observed the off-limit areas of the home were inaccessible by baby gates, locked/closed doors, and supervision.

A health and safety inspection was conducted in the areas accessible to children. LPA observed a working telephone, functioning smoke and carbon monoxide detector, and a fully charged 2A10BC fire extinguisher within the home. LPA observed home was sanitary, safe, and orderly. LPA observed that hazardous items: detergents, cleaning compounds, medication, sharp utensils, and other items that could pose a danger to children in care, are properly stored out of children's reach in up-high cabinets and child locked cabinets. LPA observed a variety of age-appropriate toys, equipment, and materials available to children within the home. LPA observed fireplace and stairs within the home are properly barricaded to meet regulations. LPA observed supervision and personal rights regulations being adhered to. Licensee stated there are no poisons, firearms, or bodies of water on the premises. Licensee understands that if there are any poisons in the home, all poisons must be locked with a key lock or combination lock.

LPA reviewed facility, staff, and children's records. LPA observed all required postings were posted and visible to authorized representatives. LPA observed a complete children's roster maintained and a fire drill log with drills being conducted and documented at least every six months. The last fire drill was conducted 08/2024. LPA reviewed records of children’s files and verified all files contained the required licensing forms. LPA reviewed records of Licensee and assistant files and verified both files contained the required licensing forms and documentation. LPA verified Licensee has current EMSA approved pediatric CPR/First Aid training, which expires 03/2025. Mandated Reporter Training for licensee and assistant expired 03/2023. Licensee understands both CPR and mandated reporter training's’ must be completed every two years.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

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: MATTE, SARA	FACILITY NUMBER: 343622164
	VISIT DATE: 01/27/2025

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LPA observed safe sleep practices were being followed and LPA observed 15 minute sleep checks being conducted and documented for all children under 2 years old. 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-andresources/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.

All individuals subject to criminal background review have obtained a criminal record clearance. 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.

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 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.

During today’s inspection, one type B deficiency was cited on 809-D. 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. Exit interview conducted and report was reviewed with the licensee. Appeal Rights provided. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/27/2025 11:45 AM - It Cannot Be Edited

Created By: Soleil Marx On 01/27/2025 at 11:30 AM

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: MATTE, SARA	FACILITY NUMBER: 343622164
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/27/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child 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 by Licensee and assistant having expired Mandated Reporter Training which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/10/2025
	Plan of Correction
1 2 3 4	Licensee and assistant will renew their mandated reporter training and send current proof of certification to LPA Marx by POC due date. Licensee will send POC to soleil.marx@dss.ca.gov

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:

Soleil Marx

LICENSING EVALUATOR SIGNATURE:

DATE: 01/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2025

LIC809 (FAS) - (06/04)

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