Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304204980
Report Date: 02/12/2019
Date Signed: 02/12/2019 01:49:14 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:RASPPERRY, LAURA ANNFACILITY NUMBER:
304204980
ADMINISTRATOR:RASPPERRY, LAURA ANNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
7148713653
CITY:FULLERTONSTATE: CAZIP CODE:
92833
CAPACITY:14CENSUS: DATE:
02/12/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:46 AM
MET WITH:Laura RaspperryTIME COMPLETED:
12:15 PM
NARRATIVE
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An Annual Random inspection was conducted at the facility by Licensing Program Analyst (LPA) Leonor Barajas and LPM Rina Lopez. A review of adult records indicates that all facility residents, staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are presently 3 adults living in the home, licensee, husband Eric and son Tim Raspperry. During today’s inspection the home and grounds were toured and the licensee was operating within the licensed capacity. There were 4 infants, 3 toddlers and 1 school age children in care. Operating hours are 6AM to 6PM, Monday through Friday.

The floor plan was verified. Off limits areas are made inaccessible by means of baby gates and door latches. The children use the front yard as the outdoor play area, and it is completely fenced. The outdoor play area is free from hazards. There is a swimming pool in the backyard which is off limits. The pool meets regulations, and gate is self-latching. There is a fireplace and inaccessible to children in care. Items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Poisonous items are not stored on site, and none were observed during today's inspection. The home provides safe toys, equipment, and materials. During today’s inspection each child was observed to have safe, healthful, and comfortable accommodations, furnishings, and equipment. There is a working carbon monoxide detector, smoke detector, and fire extinguisher in the home that meet statutory and State Fire Marshall standards. The licensee has a current roster of children in care. The facility has conducted an emergency drill within the past six months. The licensee stated there are no firearms and/or other dangerous weapons in the home and none were observed during today's visit.

The licensee's pediatric CPR/First Aid certification is current, which expires 05/16/19. Children's records were reviewed for completeness. 6 out 7 children were missing the blue immunization card. Proof of immunization against influenza (or written decline) pertussis and measles for licensee(s)/assistants/volunteers were reviewed and within compliance of SB 792.

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SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Leonor BarajasTELEPHONE: (714) 703-2825
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2019
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
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: RASPPERRY, LAURA ANN
FACILITY NUMBER: 304204980
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/12/2019
Section Cited
CCR
102418(g)(1)
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102418(g) Immunization. g)The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.(1) This requirement includes updating each... family day care home. This requirement is not met as evidenced by:
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Licensee stated will get the information from parents submit a certification letter stating deficiencies are being corrected by 02/22/2019.
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Based on observation and interviews, LPA Barajas while reviewing childrens files did not observe in 6 out of 7 files children immunzations and blue cards. This poses a potential risk to the health and safety of children in care.
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Type B
02/12/2019
Section Cited
HSC
1596.8662(b)(1)
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1596.8662(b)(1)-(b)(1)On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training ...This requirement is not met as evidenced by:
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The licensees stated she and her assistants will complete the mandated reporter training and submit proof of completion to licensing by the due date of 02/19/2019.
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Based on observation and interview, Proof of completion of required mandated reporter training was not available for review for licensee, and two assistants during today's inspection. This poses a potential health and safety risk to children in care.
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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: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Leonor BarajasTELEPHONE: (714) 703-2825
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2019
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: RASPPERRY, LAURA ANN
FACILITY NUMBER: 304204980
VISIT DATE: 02/12/2019
NARRATIVE
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The following violations of the California Code of Regulations, Title 22; Division 12, were observed and cited today: see LIC 809D.

Inspection, report review and exit interview was conducted. Notice of Site Visit was posted during the visit. Facility representative was informed that the notice of site visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Appeal rights provided and explained. The licensee was provided a copy of their appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. First level appeals should be sent to the regional manager to the address listed above. Licensee was informed of how/where to access regulations and forms from CCLD website: www.ccld.ca.gov.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Leonor BarajasTELEPHONE: (714) 703-2825
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2019
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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: RASPPERRY, LAURA ANN
FACILITY NUMBER: 304204980
VISIT DATE: 02/12/2019
NARRATIVE
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The licensee stated she is present in the home and ensures that children in care are supervised at all times. The licensee stated, does not transport children. The licensee states when temporarily absent from the home, she arranges for a substitute adult to care for and supervise children in her absence.

Beginning March 31,2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years, per A.B.1207. The licensee does not have proof of compliance as specified in A.B.1207.

This facility provides Incidental Medical Services – IMS.LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 .

Facility was advised on how to receive notifications for quarterly updates and provided with Child Care Advocate contact information: childcareadvocatesprogram@dss.ca.gov. A hard copy of the 2016 “A Child Care Providers Guide to Safe Sleep” was provided to the licensee in English. The following electronic links were also provided:
English: https//www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf
Spanish: https//www.cdph.ca.gov/programs/SIDS/Documents/ChildCareProvSleepSPAN2011.pdf
AAP: https://www.healthychildren.org/English/ages-stages/baby/sleep/Pages/A-Parents-Guide-to-Safe-Sleep.aspx, NIH: https://safetosleep.nichd.nih.gov/safesleepbasics/environment/room/text_alternative,
Safe to Sleep Campaign: https://safetosleep.nichd.nih.gov/materials.

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SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Leonor BarajasTELEPHONE: (714) 703-2825
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2019
LIC809 (FAS) - (06/04)
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