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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343623496
Report Date: 02/03/2022
Date Signed: 02/03/2022 10:09:11 AM

Document Has Been Signed on 02/03/2022 10:09 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:NORMAN, LATASHAFACILITY NUMBER:
343623496
ADMINISTRATOR:NORMAN, LATASHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 397-6221
CITY:SACRAMENTOSTATE: CAZIP CODE:
95823
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
02/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Latasha NormanTIME COMPLETED:
10:20 AM
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Licensing Program Analysts (LPAs) Gagandeep Singh and Arianna Manabat met with the licensee, Latasha Norman, for a required annual inspection. Purpose of the inspection was explained. Licensee lives in a single family home. Present, there are four children (including licensee’s own child) in care with licensee and one helper, Teresa Massingale. All adults living or working in the home have criminal background check on file. Licensee is operating within the capacity of this date. Per licensee, licensee is available for business 24 hours a day.

LPA inspected the day care areas with the licensee. Day Care Areas: Living room, Day care room on left side of main entrance, Kitchen, Day care area on right side of kitchen, hallway, Bathroom in the hallway and Backyard. Off limit areas: All bedrooms, and Garage. There is no pool, spa or any other body of water in the house. LPAs observed the fire arm being secured in a locked storage. All the cleaning supplies, poisons and other chemicals are stored inaccessible to the children. Fireplace is barricaded with furniture and is inaccessible for children. 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.

LPA reviewed the facility records. LPA observed licensee has License and other required documents posted in the child care areas. LPAs observed the training of preventive health and CPR has been expired. Licensee stated that licensee has signed up for renewal training. LPA remind the licensee to conduct the fire or emergency drills at least once every six months and drills must be logged. Per licensee, last drill was conducted in November 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. See next page for continuation ................
SUPERVISORS NAME: Maria Mayorga
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE: DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2022
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 02/03/2022 10:09 AM - It Cannot Be Edited


Created By: Gagandeep Singh On 02/03/2022 at 09:34 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: NORMAN, LATASHA
FACILITY NUMBER: 343623496

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above as LPAs did not observe a valid CPR training certificate on file, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/03/2022
Plan of Correction
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Licensee agreed to obtain a EMSA approved CPR training before March 03, 2022.
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:Maria Mayorga
LICENSING EVALUATOR NAME:Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:
DATE: 02/03/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/03/2022


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: NORMAN, LATASHA
FACILITY NUMBER: 343623496
VISIT DATE: 02/03/2022
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Continuation from previous page ..........

LPAs discussed the safe sleep regulation with the licensee and provided a copy of PIN 20-24-CCP. 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 reminded the licensee 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.

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


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.

See next page for deficiency cited today. The copy of this report is reviewed and provided to the licensee. 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: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
LIC809 (FAS) - (06/04)
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