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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343625841
Report Date: 06/26/2024
Date Signed: 06/26/2024 10:43:03 AM

Document Has Been Signed on 06/26/2024 10:43 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:GLOWNIAK, JENNIFERFACILITY NUMBER:
343625841
ADMINISTRATOR/
DIRECTOR:		GLOWNIAK, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 792-5990
CITY:FOLSOMSTATE: CAZIP CODE:
95630
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/26/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Jennifer GlowniakTIME VISIT/
INSPECTION COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Jennifer Velasco met with Licensee Jennifer Glowniak (Licensee), for the purpose of an announced change of location pre-licensing inspection from previous facility, 343622036. Fire clearance for this facility was granted 06/21/2024. 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, 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 five 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. All individuals subject to criminal background review have obtained a criminal record clearance. Hours of operation will be: Monday through Friday from 7:30 AM-5:00 PM. Parents are apprised of planned closures. Licensee stated care will be provided to children two years of age and older.

LPA conducted a health and safety inspection of the interior and exterior of the home. Off-limits areas include: Entire second floor, gated stairs to the second floor, kitchen, family room, downstairs office, fenced pool area, and garage. Applicant understands children may never enter off-limit areas. Toxic and hazardous items, sharp knives, and medications are inaccessible to children. LPA observed a functioning smoke detector, carbon monoxide detector, and a fully charged 2A10BC fire extinguisher within the home. LPA observed fireplace properly barricaded to meet regulation. Applicant stated that there are no poisons in the home. LPA advised the applicant that if there are ever any poisons at the home, all poisons must be locked with a key lock or combination lock. Applicant stated there are no weapons or bodies of water on the premises. Applicant provided proof of control of property.

Applicant has completed the required Preventative Health and Safety course with the Lead Poisoning Prevention training. Current EMSA approved pediatric CPR/First Aid training and Mandated Reporter training were completed. Applicant understands CPR and Mandated Reporter training must be completed every two years.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE: DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: GLOWNIAK, JENNIFER
FACILITY NUMBER: 343625841
VISIT DATE: 06/26/2024
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 LPA explained to applicant that if they relocate and want to continue to provide care, they must submit a change of location application and have the new home inspected. 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, licensing must be notified and LPA must do an inspection before children are allowed in the area. Applicant understand that licenses are not transferable, and once licensed, licensees must live in the home and be present for 80% of the operating hours.

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. 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.

Though Licensee does not enroll infants, LPA discussed with Applicant safe sleep regulations and 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 applicant 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.

On 06/24/2024, 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.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
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: GLOWNIAK, JENNIFER
FACILITY NUMBER: 343625841
VISIT DATE: 06/26/2024
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SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: GLOWNIAK, JENNIFER
FACILITY NUMBER: 343625841
VISIT DATE: 06/26/2024
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Applicant was informed of the MyChildCarePlan.org site, 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. 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 platforms. To receive important information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

The following items are required before a license will be issued:


1. The first gate to the off-limits pool area must be self-closing and self-latching
2. Adult residing in the home must have tuberculosis clearance from within 12 months.
Exit interview was conducted and report was reviewed with the applicant, Jennifer Glowniak.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4