343623990-8-8-2024-03-CC-ASUR-D7XNH4-20240808102806

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343623990
Report Date: 08/08/2024
Date Signed: 08/08/2024 10:28:16 AM

Document Has Been Signed on 08/08/2024 10:28 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:	BOOKER, SARAH		FACILITY NUMBER:	343623990
ADMINISTRATOR/ DIRECTOR:	SARAH BOOKER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 910-5127
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95824
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	08/08/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Sarah Booker		TIME VISIT/ INSPECTION COMPLETED:	10:45 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On Thursday, August 8, 2024, Licensing Program Analysts (LPAs) Amanda Sutter and Mandie Goodwin met with Licensee, Sarah Booker, for the purpose of an unannounced annual inspection. Upon arrival, LPA observed licensee’s assistant supervising 6 children. Licensee arrived about 15 minutes later with 3 children. Licensee’s adult relative was also present at the facility. All individuals subject to criminal background review have obtained a criminal record clearance. LPA observed proper ratio and capacity was being followed. Facility hours of operation are Monday through Friday from 6:00 AM to 4:00 PM. A health and safety evaluation was conducted in all areas accessible to children. Off-limit areas include: entire upstairs, garage, laundry room, and all downstairs bedrooms. Licensee acknowledged that children may never enter these off-limit areas. LPAs observed that the facility is clean, safe, sanitary, and in good repair. LPAs observed a functioning smoke detector, carbon monoxide detector, and a full 2A10BC fire extinguisher. The facility has adequate toys that appear to be safe for children to use. LPA observed a weapon stored appropriately according to regulation. LPAs observed stairs to be barricaded according to regulation. The backyard is fenced. LPAs reviewed four children’s files which were observed to be complete. Required postings and the children’s roster were observed. LPAs observed infant sleep plan (LIC 9227). Licensee stated that she does not have current 15-minute observation checks for napping infants. The facility has record of conducting fire drills at least every 6 months. The last fire drill was conducted 5/8/2024. Licensee’s CPR/First Aid card expires 6/2025. Licensee’s assistant also has a current CPR/First Aid certification that expires 1/3/2025. Licensee’s Mandated Reporter certificate expires 6/14/2024. Licensee understands that trainings must be completed every two years. LPAs verified that the annual fees are current. 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. *PAGE 1. REPORT CONTINUES ON LIC809-C*

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

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: BOOKER, SARAH	FACILITY NUMBER: 343623990
	VISIT DATE: 08/08/2024

NARRATIVE

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LPAs 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. LPAs 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.

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/process.

Based on the inspection, one Type B citation has been issued. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Sarah Booker. During the exit interview, the Licensee Sarah Booker, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Appeal Rights were provided.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 08/08/2024 10:28 AM - It Cannot Be Edited

Created By: Amanda Sutter On 08/08/2024 at 10:02 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: BOOKER, SARAH	FACILITY NUMBER: 343623990
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee does not have documentation of checking on infants every 15 minutes while they are sleeping, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/23/2024
	Plan of Correction
1 2 3 4	LIcensee will submit proof of 15 minute sleep checks to LPA Sutter by date listed above.

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:

Seychelle De Luca

LICENSING EVALUATOR NAME:

Amanda Sutter

LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

LIC809 (FAS) - (06/04)

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