343625264-9-15-2023-03-CC-JVEO-CVPNTG-20230915104443

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343625264
Report Date: 09/15/2023
Date Signed: 09/15/2023 10:44:54 AM

Document Has Been Signed on 09/15/2023 10:44 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	GREEN, TAYLOR		FACILITY NUMBER:	343625264
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	09/15/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Taylor Green		TIME COMPLETED:	11:00 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst Jennifer Velasco (LPA) met with Applicant Taylor Green (L1) to conduct an announced Pre-Licensing inspection for this relocated facility, formerly licensed at a different location as 343623900. LPA toured L1's home. All adults currently living or working in the home have received a criminal background clearance and are associated to the facility. Licensee provided proof of control of property. L1 stated the facility hours will be Monday - Friday, 7:00 AM – 6:00 PM. L1 was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 five 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. On 09/12/2023, the California Attorney General - Megan's Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ. Off-limit areas will consist of: Left and right side of backyard, three bedrooms, two bathrooms, the kitchen, garage and outbuilding. L1 understands that children may never enter the off-limit areas. L1 acknowledges she is required to notify Licensing prior to making changes to the home or yard so that they may be inspected for safety. LPA observed a functioning smoke and carbon monoxide detector and 2A-10-BC fire extinguisher. Page one of three

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

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: GREEN, TAYLOR	FACILITY NUMBER: 343625264
	VISIT DATE: 09/15/2023

NARRATIVE

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Hazardous cleaning products and chemicals, knives, and medications are all stored inaccessible to children. L1 understands that poisons must be locked. The backyard is fenced. LPA advised L1 in areas that are not fenced, 100% supervision must be maintained at all times. L1 stated she does not have any firearms and LPA did not observe any bodies of water.

LPA reviewed with Licensee LIC 311 D, Forms/Records to Keep In Your Family Child Care Homes, children's forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. L1 has a current pediatric CPR/First Aid certificate and has completed the preventative health and safety course. L1 has completed the Mandated Reporter training and has provided proof of immunizations. L1 was reminded that the CPR/First Aid and Mandated Reporter certificates must be updated every two years. LPA obtained proof that the L1 lives in the home. L1 understands that if she does not have liability insurance, she will have parents fill out an affidavit.

LPA reviewed current COVID-19 guidelines, postings, and protocols. LPA reviewed Type A and Type B citations, Zero Tolerance, and Civil Penalties. LPA reviewed open door policy, supervision, fire drills, children’s personal rights, reporting requirements, and the smoking prohibition with the L1. A current roster of children enrolled must be available and maintained for a period of three years after children are no longer in care. LPA went over requirements for an assistant. LPA reminded L1 that annual fees must be paid promptly and by the due date or late fees will be assessed. LPA advised L1 that she has the option to put her home on Inactive Status at any time for up to a year while continuing to pay fees.

LPA discussed with L1 the safe sleep regulations and 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 L1 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.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

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: GREEN, TAYLOR	FACILITY NUMBER: 343625264
	VISIT DATE: 09/15/2023

NARRATIVE

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Licensee plans to provide meals and snacks and stated food allergies will be monitored and any allergenic foods will not be offered.

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) or (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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN) and Program Quarterly Update Newsletters. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication. Applicant was informed of the MyChildCarePlan.org site, 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.

As of today's date, September 15, 2023, Licensee is now licensed at this location as a Small Family Child Care Home with a capacity of 6 children with no more than 3 infants, or 4 infants only, or up to 8 children with no more than 2 infants, 1 child in Transitional Kindergarten or above and 1 child at least age 6. Infants are children under the age of 2. Exit interview was conducted and report was reviewed with Licensee Taylor Green. A notice of site visit was given to Lice see and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:	DATE: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

LIC809 (FAS) - (06/04)

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