343618165-11-16-2023-03-CC-SMAX-CXMU76-20231116141925

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343618165
Report Date: 11/16/2023
Date Signed: 11/16/2023 02:19:32 PM

Document Has Been Signed on 11/16/2023 02:19 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	CHOWDHURY, RUHINA		FACILITY NUMBER:	343618165
ADMINISTRATOR:	CHOWDHURY, RUHINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 693-0310
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	11/16/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Ruhina Chowdhury		TIME COMPLETED:	02:45 PM

NARRATIVE

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Licensing Program Analyst (LPA) Soleil Marx and Stephanie Piring, met with Licensee, Ruhina Chowdhury, for an unannounced annual / one year inspection. During the inspection LPAs observed a census of eight children being supervised by the licensee and assistant. Facilities hours of operation are Monday through Friday 08:30 AM to 05:30 PM.

A health and safety inspection was conducted in the areas accessible to children. The off-limits areas include: upstairs, and garage. Licensee understands that children may never enter off-limit areas.

LPAs observed a working telephone, functioning smoke and carbon monoxide detector, and a 2A10BC fire extinguisher within the home. LPAs observed home was safe, orderly, and free of hazards. LPAs observed a variety of age-appropriate toys within the home. LPAs observed fireplace and stairs within the home barricaded. Licensee understands that if there are any poisons in the home, all poisons must be locked with a key lock or combination lock. Licensee stated there are no firearms or bodies of water on the premises.

LPAs observed all required postings, a children's roster and fire drill log, the last fire drill was conducted 08/2023. LPAs reviewed records of children’s files and licensee's file, all which contained the required documentation. Licensee has current EMSA approved pediatric CPR/First Aid training, which expires 03/2025. Licensee has current Mandated Reporter Training, which expires of 06/2024. Licensee understands both CPR and mandated reporter training's’ must be completed every two years.

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.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:	DATE: 11/16/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CHOWDHURY, RUHINA	FACILITY NUMBER: 343618165
	VISIT DATE: 11/16/2023

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LPAs 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-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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 PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Based on today's inspection, one type B Title 22 deficiency is being cited on 809-D.

During the exit interview, the licensee, Ruhina Chowdhury, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Exit interview conducted and report was reviewed with the licensee, Ruhina Chowdhury. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:	DATE: 11/16/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

Document Has Been Signed on 11/16/2023 02:19 PM - It Cannot Be Edited

Created By: Soleil Marx On 11/16/2023 at 02:00 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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: CHOWDHURY, RUHINA	FACILITY NUMBER: 343618165
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416.1(a)

Personnel Records

(a) Personnel records shall be maintained on each employee and shall contain the following information: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above by not having assistant files which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 12/18/2023
	Plan of Correction
1 2 3 4	Licensee will submit to LPA completed files for staff assistants by POC due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Natalie Dunaway

LICENSING EVALUATOR NAME:

Soleil Marx

LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023

LIC809 (FAS) - (06/04)

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