343623021-5-15-2023-03-CC-AMAT-CRUQLE-20230515121548

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623021
Report Date: 05/15/2023
Date Signed: 05/15/2023 12:16:08 PM

Document Has Been Signed on 05/15/2023 12:16 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:	BASS, AMANI		FACILITY NUMBER:	343623021
ADMINISTRATOR:	BASS, AMANI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 706-4191
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95833
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 4	DATE:	05/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Amani Bass		TIME COMPLETED:	12:30 PM

NARRATIVE

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On 05/15/2023 at approximately 9:50AM, Licensing Program Analyst (LPA) Arianna Manabat met with Licensee Amani Bass for an unannounced annual / one year inspection. During the inspection there were four children in care with the Licensee. All individuals subject to criminal background review have obtained a criminal record clearance. During today's visit, LPA has toured the one-story home and all areas accessible to children in care. LPA have noted that the off-limits areas are the following: the garage, all rooms, and the shed. During today's visit, LPA has changed the off-limits to all rooms per Licensee's request. The Licensee stated that there are no firearms or bodies of water on the premises. Facility's hours of operation are 7:00AM to 7:00PM Monday through Friday.

A health and safety inspection was conducted in the areas accessible to children. The house has a working telephone, fully charged fire extinguisher, smoke detector and carbon monoxide detector that meet regulations. LPA has observed all the required postings. LPA advised the licensee that if there are any poisons at the home, all poisons must be locked with a key lock or combination lock. During today's visit, LPA observed a variety of chemical compounds accessible to children in care. Please see the LIC809-D for more information. LPA did not observe a fireplace within the facility.

Licensee has all of her immunization records current. Children's roster and a current fire drill log were observed. Licensee's CPR/First aid card had an expiration date of 02/2024. The Licensee's Mandated Reporter Training was due 6/9/2023. Licensee understands training must be complete every two years. LPAs observed complete children's files.

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 Report continues on 809C....

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

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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Document Has Been Signed on 05/15/2023 12:16 PM - It Cannot Be Edited

Created By: Arianna Manabat On 05/15/2023 at 11:37 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BASS, AMANI	FACILITY NUMBER: 343623021
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102417(g)(4)

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. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	LPA observed a grass/weed killer chemical near the side shed and cleaning chemicals such as Comet Bleach in an unlocked cabinet. LPA observed the Licensee immediately correct, and remove, the chemicals upon request. Although immediately removed, these chemicals had been previously accessible to children. This had posed an immediate health and saftey risk to children in care.
	POC Due Date: 05/16/2023
	Plan of Correction
1 2 3 4	Through observation, the Licensee has witnessed the Licensee take immediate action to correct the deficiency. During today's visit, LPA has cleared the deficiency and issued a letter of clearance to the Licensee.

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:

Amanda Blesi

LICENSING EVALUATOR NAME:

Arianna Manabat

LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: BASS, AMANI	FACILITY NUMBER: 343623021
	VISIT DATE: 05/15/2023

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…… Continued from previous 809 page..........

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

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.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Based on the inspection, Title 22 Deficiencies have been issued on the attached on the LIC 809-D page. The Licensee was informed that this report dated on 05/15/2023 documents one Type A citation which shall be posted for 30 consecutive days. The Licensee shall also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

A signed Acknowledgement of Receipt of the Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. The Licensee has been provided with appeal rights.

SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Arianna Manabat
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2023

LIC809 (FAS) - (06/04)

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