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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313609155
Report Date: 10/25/2021
Date Signed: 10/25/2021 02:15:39 PM

Document Has Been Signed on 10/25/2021 02:15 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:FASIG, LARRYFACILITY NUMBER:
313609155
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
10/25/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Larry Fasig - LicenseeTIME COMPLETED:
02:30 PM
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Licensing Program Analysts (LPA) Katrina Owens met with licensee, Larry Fasig for an Annual Required 1 year inspection and a capacity increase from 8 to 14 children. Present at time of inspection were licensee, his wife and 6 day care children. LPA toured the home inside and out, and reviewed forms for children's records. He understands that until a policy is obtained, he must use the affidavit.

Applicant has certificates of completion for 15 hours of health and safety training including CPR and First Aid with expiration date of 01/2023. Fire clearance was approved on 10/13/2021. LPA discussed the maximum capacity worksheet with licensee.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Licensee, Larry Fasig, 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 has provided the licensee with the web site to enable access to all updated forms, requirements and changes. Licensee understands that he needs to notify licensing for any modification inside and out of the home.

Off-limit areas includes Garage and Master Bathroom.. Licensee understands that children may never enter these off-limit areas. LPA observed the fire drill log. Licensee stated there are no weapons in the home. Fire extinguisher, carbon monoxide detector and smoke detectors meet regulation. Hazardous cleaning compounds are inaccessible to children. Sharp utensils and medications are inaccessible to children. The backyard is fenced and there are no bodies of water. Licensee understands that 100% supervision is required in any unfenced areas. There is no pool at the home. There are no pets at the home. There are no stairs at the home. Planned hours of operation are Monday through Friday, 6:30 am to 6:00 pm and other hours as arranged.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE: DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/25/2021
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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: FASIG, LARRY
FACILITY NUMBER: 313609155
VISIT DATE: 10/25/2021
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LPA observed proof that licensee and staff/ volunteers have met the requirements of SB 792.
LPA observed that all staff has completed the required mandated reporter training (AB 1207) at website: www.mandatedreporterca.com.

LPA observed Safe Sleep plan and logs for infants/ children in care. LPA discussed the Effects of Lead Exposure brochure.

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



LPA provided the Community Care Licensing website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms. LPA advised licensee of their responsibility to stay current in regards to new regulations. LPA also included the email address for the children's advocacy program to stay current on new laws [email protected].

Effective today 10/25/2021 applicant is a license to serve up to either 14 children, (WHEN THERE IS AN ASSISTANT PRESENT), 12 children -No more than 4 infants. Capacity 14 - No more than 3 infants. 1 Child in Kindergarten or Elementary school and 1 child at least age 6.

Exit Interview were conducted.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2021
LIC809 (FAS) - (06/04)
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