343624239-7-13-2023-03-CC-JMCN-CTPNRV-20230713104210

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343624239
Report Date: 07/13/2023
Date Signed: 07/13/2023 10:42:20 AM

Document Has Been Signed on 07/13/2023 10:42 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:	ROJAS, MERCEDES		FACILITY NUMBER:	343624239
ADMINISTRATOR:	ROJAS, MERCEDES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 889-7701
CITY:	RANCHO CORDOVA	STATE: CA	ZIP CODE:	95670
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	07/13/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Mercedes Rojas		TIME 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 07/13/2023 Licensing Program Analysts (LPAs) Jeremey McClain and Carla Polanco Rivera conducted a Pre-Licensing inspection with applicant Mercedes Rojas. This is an announced follow up inspection for the inspection made conducted on 03/23/2023. Applicant is applying for a change of location for a large family child care. A health and safety inspection of the home was conducted. The tri-level home has 3 bedrooms, 3 bathrooms, a kitchen with dining area, a living room, playroom, baby's room, a laundry room, garage, fenced side patio, and fenced backyard. The off-limit areas in the home are entire upstairs, garage, laundry room, living room, office, backyard, and kitchen. The off-limits areas in the home will be the upstairs, the laundry room, the and the garage. Off-limits areas will remain inaccessible to children by closed doors and or supervision. Applicant plans to operate Monday through Friday from 7 am to 5:30 pm. The fireplace in the living room is appropriately barricaded to prevent access by children. Stairs are barricaded by a gate. The home appeared clean and orderly, and toxic and hazardous items are inaccessible to children. Functioning smoke and carbon monoxide detectors and a 2A10BC fire extinguisher were observed in the home. Current pediatric CPR and first aid training was verified and expires 03/2024. Applicant stated there are no weapons in the home. Applicant has a pool with a fence that is at least 5 ft. high, with a self-latching gate that opens away from the pool. The fence is not climbable and there less than a foot from the bottom of the fence and the ground. Applicant also has a spa with a cover is locked on four sides to prevent access. Although there is no risk for access to the spa, LPA advised that another lock or crossbar be added. Applicant has provided proof of Immunization for Pertussis, Measles and Influenza. Tuberculosis clearances for all adults in the home have been provided. *Continued...*

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023

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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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: ROJAS, MERCEDES	FACILITY NUMBER: 343624239
	VISIT DATE: 07/13/2023

NARRATIVE

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Applicant has completed the required AB1207 Mandated Reporter training which must be renewed 05/2024. Applicant understands that the training must be completed once every two years, and that Mandated Reporter trainings offered outside of http://childcare.mandatedreporterca.com/ , must be approved by the department.

All individuals subject to criminal background review have obtained a criminal record clearance. Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

On this date, 07/12/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant understands that any adult assistants for the childcare must also obtain the following: EMSA certified CPR and first aid training, immunizations for measles Pertussis and Influenza, complete AB1207Mandated Reporter Training, and complete eight hours of preventative health and safety training.

Applicant understands that licenses are not transferable, and once licensed, licensee must live in the home and be present for 80% of the operating hours. Applicant was encouraged to always maintain supervision. LPA advised applicant that 100% supervision is required in areas outside of the home that are unfenced.

LPA explained to applicant that if they move and want to continue to provide care, they must submit a change of location application and have the new home inspected.

LPA discussed Unusual Incidents and reporting requirements. Applicant understands that if an unusual incident occurs, licensing is to be notified via phone call, e-mail or fax within 24 hours and the Unusual Incident Report LIC 624 shall be submitted within seven days to remain in compliance. Continued...

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ROJAS, MERCEDES	FACILITY NUMBER: 343624239
	VISIT DATE: 07/13/2023

NARRATIVE

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Applicant understands that if any structural changes are made to the home; licensing must be notified prior to construction. Applicant understands that if they want to make any off-limit area an ON-limits area, they must notify licensing and LPA must do an inspection BEFORE children are allowed in the area.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

Applicant understands that children’s records are to be maintained and be accessible to licensing for up to three years after the child is no longer enrolled. LPA discussed the necessity for applicant to obtain and record children’s immunizations on form PM 286. Applicant understand that is they do not attain a $300,000 liability insurance policy, form LIC 282 must be provided to parents.

LPA discussed capacity and ratios with applicant. LPA verified applicant's telephone number.

LPA informed applicant that all inspections after today will be unannounced.

Immediate Civil Penalties were discussed. LPA informed applicant of smoking prohibition.

LPA discussed the safe sleep regulations with applicant, 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 [applicant, licensee, or 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.

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) or (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. Continued...

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ROJAS, MERCEDES	FACILITY NUMBER: 343624239
	VISIT DATE: 07/13/2023

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the applicant

Effective today, 07/13/2023, applicant is approved for a (Provisional if necessary) Large Family Child Care License. Applicant can provide care for 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of two years. Licensee understands that when there is no assistant present, ratios of a small capacity must be adhered to.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2023

LIC809 (FAS) - (06/04)

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