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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 233010008
Report Date: 01/14/2025
Date Signed: 01/14/2025 01:14:31 PM

Document Has Been Signed on 01/14/2025 01:14 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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:RYAN, SARAH FCCHFACILITY NUMBER:
233010008
ADMINISTRATOR/
DIRECTOR:		RYAN, SARAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 841-0043
CITY:BOONVILLESTATE: CAZIP CODE:
95415
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 6DATE:
01/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:34 AM
MET WITH:Sarah RyanTIME VISIT/
INSPECTION COMPLETED:
01:19 PM
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An annual required inspection was made to the facility by Licensing Program Analyst (LPA), Robert Maciel. LPA met with Licensee, Sarah Ryan. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Licensee was reminded that all adults 18 and over living or working in the home, 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 5 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. There are currently two adults living in the home.

During the inspection the home was toured inside and outside. The licensee was supervising 6 children and operating within the licensed capacity and ratio requirements. The facility’s operating hours are Monday - Thursday 9:00 AM - 5:00 PM. The floor plan submitted by the licensee was reviewed and verified. The children will have access to the classroom, bathroom 1, and the front yard. The off-limits area of the home are the back yard, kitchen, living room, bedrooms 1, 2, and 3, and bathrooms 2 and 3. The off-limits areas of the home were made inaccessible by door latches and door locks. The home appears to be clean and orderly and was at a comfortable indoor temperature. There were safe toys and equipment available for children. There is a working telephone in the home. Items which could pose a danger to children (such as detergents, cleaning compounds, medications, etc.) were observed to be stored out of the reach of children. Licensee stated poisons are not stored in the facility and none were observed. LPA observed a working smoke detector, a carbon monoxide detector and a fire extinguisher rated at least 2-A:10-B:C in the home.

Continued on LIC 809-C

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE: DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/14/2025
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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: RYAN, SARAH FCCH
FACILITY NUMBER: 233010008
VISIT DATE: 01/14/2025
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The roster of children in care was reviewed. The licensee has conducted an emergency drill within the past six months. The licensee stated there are no firearms in the home and none were observed. The home's front yard is fully fenced. At 12:07 PM, five children's records were reviewed (C1 - C5) which contained all records as required. At 11:45 AM, Facility and personnel files were reviewed which revealed that staff 2 (S2) did not possess current mandated reporter training certificate, proof of immunization for measles and pertussis, and a tuberculosis screening.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. 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.

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 informed of the MyChildCarePlan.org website; 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.



Continued on LIC809-C
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
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
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: RYAN, SARAH FCCH
FACILITY NUMBER: 233010008
VISIT DATE: 01/14/2025
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A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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/process

The following violation of the California Code of Regulation, Title 22, Division 12, was cited: see LIC809-D. Appeal Rights were provided. Exit interview conducted and report was reviewed with the licensee, Sarah Ryan.

SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/14/2025 01:14 PM - It Cannot Be Edited


Created By: Robert Maciel On 01/14/2025 at 12:53 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: RYAN, SARAH FCCH
FACILITY NUMBER: 233010008

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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2
3
4
Based on record review, staff 2 (S2) did not possess a current mandated reporter training certificate which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/04/2025
Plan of Correction
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2
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Licensee stated she would obtain S2's current mandated reporter training certificate and send a copy to LPA by email at robert.maciel@dss.ca.gov
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, staff 2 (S2) did not possess proof of immunization for measles and pertussis, and a tuberculosis screening which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/04/2025
Plan of Correction
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Licensee stated she would obtain S2's proof of immunization for measles and pertussis, and a tuberculosis screening and send a copy to LPA by email at robert.maciel@dss.ca.gov
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:Erin Virrueta
LICENSING EVALUATOR NAME:Robert Maciel
LICENSING EVALUATOR SIGNATURE:
DATE: 01/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/14/2025


LIC809 (FAS) - (06/04)
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