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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393608771
Report Date: 08/27/2024
Date Signed: 08/27/2024 01:41:59 PM

Document Has Been Signed on 08/27/2024 01:41 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:FUNDERBURK, PATRICIAFACILITY NUMBER:
393608771
ADMINISTRATOR/
DIRECTOR:		PATRICIA FUNDERBURKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 825-4486
CITY:MANTECASTATE: CAZIP CODE:
95337
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
08/27/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:45 PM
MET WITH:Patricia FunderburkTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Janie Davis met with Licensee, Patricia Funderburk for the purpose of an unannounced annual inspection. There were twelve children present at the time of inspection, and one assistant Kayla Funderburk. Licensee's operating hours are Monday through Friday from 7:00 AM. to 5:00 PM. LPA verified all fees are current.

All adults subject to criminal background review have obtained criminal record clearance. 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.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the entire upstairs, garage, loft above garage, laundry room and side yard. At time of inspection, shed in the backyard. 2A10BC fire extinguisher meets regulations. LPA observed smoke and carbon monoxide detectors, and verified they were both functional. LPA toured the kitchen area and verified knives were inaccessible to children in care. LPA observed play room area with age appropriate toys for children. LPA observed a restroom and verified that hazardous and toxic items were inaccessible to children in care.LPA1 conducted a weapons inspection and verified that the locked firearm is stored separately from ammunition.Outdoor play space is fenced. There are no bodies of water on the premises .

Children's files were reviewed. Emergency information and required immunization records were on file. LPA observed a current roster and documentation that a fire drill is conducted at least once every six months. Licensee's immunization records are available in the facility file. Current EMSA pediatric CPR and First Aid certification was verified and expires 04/2025 and Child Care Provider Mandated Reporter certification was verified and expires 02/2025.
Continues on LIC809-C......
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE: DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/27/2024
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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: FUNDERBURK, PATRICIA
FACILITY NUMBER: 393608771
VISIT DATE: 08/27/2024
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LPA 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. LPA observed 15min infant napping log for infants 24 months and under. LPA observed copies of LIC 9227 Individual Sleeping Plan for infants under 12 months. LPA 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.
Licensee provided copy of liability insurance which is $300,000 for every occurrence.
This provider is not currently providing Incidental Medical Services (IMS) services to children in care. 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

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.

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

Exit interview was conducted and report was reviewed with the licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
In the areas that were evaluated, no deficiencies were cited during today’s inspection.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Janie Davis
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024
LIC809 (FAS) - (06/04)
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