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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313623638
Report Date: 05/24/2023
Date Signed: 05/24/2023 02:23:35 PM

Document Has Been Signed on 05/24/2023 02:23 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:RUTHERFORD, JENNIFERFACILITY NUMBER:
313623638
ADMINISTRATOR:RUTHERFORD, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 906-9576
CITY:FORESTHILLSTATE: CAZIP CODE:
95631
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
05/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Jennifer RutherfordTIME COMPLETED:
02:30 PM
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At approximately 1:20pm, Licensing Program Analyst (LPA) Matthew Gallo met with Licensee Jennifer Rutherford for the purpose of an unannounced required 1-year inspection. Licensee's husband and 15 year old daughter were also present during the inspection. Upon arrival, LPA observed a total census of 6 children, including 1 infant and 5 preschool children.

Licensee guided LPA on a tour of the facility, and a health and safety inspection was conducted in all areas accessible to children. Off-limits areas include entire second floor, outbuildings, and garage. Licensee acknowledged that children must never enter these areas. LPA observed the required postings, a working phone, 2A10BC fire extinguisher, and functioning smoke and carbon monoxide detectors. Per Licensee, there are no weapons in the home, and LPA did not observe bodies of water at the facility. Toxic and hazardous items are inaccessible to children. Stairs are properly fenced to prevent access to children. Outdoor play space is partially fenced, and licensee understands that 100% supervision is required in unfenced areas.

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.

LPA reviewed children’s files and observed them to be complete. A current roster is being maintained and fire and disaster drills are documented. Current CPR and First Aid certification was verified and expires 2/2025, and AB 1207 Mandated Reporter Training was verified for the Licensee and expires 10/2024.

Report continues LIC809-C

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE: DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/24/2023
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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: RUTHERFORD, JENNIFER
FACILITY NUMBER: 313623638
VISIT DATE: 05/24/2023
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LPA reviewed infant sleep plan (LIC 9227) requirement and 15-minute observation checks of napping infants with licensee.

LPA further discussed the safe sleep regulations with licensee and referenced 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 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 Sections 102417. When any IMS is provided an updated Plan of Operation that includes 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

No deficiencies were cited during today’s inspection.

Exit interview conducted and report was reviewed with the licensee Jennifer Rutherford. Appeal rights and a notice of site visit were provided, the latter of which must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023
LIC809 (FAS) - (06/04)
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