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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093612256
Report Date: 05/01/2023
Date Signed: 05/01/2023 11:03:35 AM

Document Has Been Signed on 05/01/2023 11:03 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:BRAUN, SUSANFACILITY NUMBER:
093612256
ADMINISTRATOR:BRAUN, SUSANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 600-2296
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
05/01/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Susan BraunTIME COMPLETED:
11:15 AM
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On May 1st, 2023, Licensing Program Analyst (LPA) Soleil Marx met with Licensee, Susan Braun, for an unannounced annual / one year inspection. During the inspection there was a census of 11 children in care being supervised by the licensee and assistant. All individuals subject to criminal background review have obtained a criminal record clearance. Facilities hours of operation are Monday through Friday 08:00AM to 04:30 PM.

A health and safety inspection was conducted in the areas accessible to children. The off-limits areas include: a portion of the garage, side yard, and back corner of yard. Licensee understands that children may never enter these off-limits areas.

The house has a working telephone, fully charged fire extinguisher, and a functioning smoke and carbon monoxide detector. LPA observed home was safe, orderly, and free of hazards. LPA observed a fireplace which is properly barricaded to meet regulations. Licensee stated there are no firearms on the premises. LPA observed a hot tub/spa on the premises, located in an off-limits area which is surrounded by a fence. The spa/hot tub is secured to meet regulations with a hard top/cover, latches on all four sides, and an additional cable lock. Licensee is aware that if there are any poisons in the home, all poisons must be locked with a key lock or combination lock.

LPA observed all required postings, a children's roster and fire drill log, the last fire drill was conducted 02/2023.

Licensee and assistant have current CPR/First aid, which expires 03/2024. Licensee and assistant have current Mandated Reporter Training, which expires 06/2023. Licensee understands both CPR and mandated reporter training's’ must be completed every two years.

LPAs reviewed records of children’s files and staff files, all which contained the required documentation. Licensee is aware of and practicing safe sleep regulations. (1/2)

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/01/2023
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: BRAUN, SUSAN
FACILITY NUMBER: 093612256
VISIT DATE: 05/01/2023
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Incidental Medical Services (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

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.

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.

No deficiencies were cited during today’s inspection.

Exit interview conducted and report was reviewed with the Licensee. A notice of site visit was provided and must remain posted for 30 days (2/2)

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
LIC809 (FAS) - (06/04)
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