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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620616
Report Date: 08/11/2022
Date Signed: 08/11/2022 04:49:48 PM

Document Has Been Signed on 08/11/2022 04:49 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:WADE, ERINFACILITY NUMBER:
313620616
ADMINISTRATOR:WADE, ERINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 847-2187
CITY:ROCKLINSTATE: CAZIP CODE:
95765
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
08/11/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Erin WadeTIME COMPLETED:
02:15 PM
NARRATIVE
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On August 11th, 2022, Licensing Program Analyst (LPA) Jeremey McClain met with Licensee Erin Wade in order to conduct a Plan of Correction inspection. Upon arrival, LPA observed care and supervision of three preschool age children and one school age child.

On May 26th, 2022, Licensee was issued Type B deficiencies for not having current AB1207 mandated reporter training nor current pediatric CPR and First aid. Licensee was also issued Type B deficiencies for not having record of children’s immunizations. A plan of correction was discussed, and a date was agreed upon for licensee to bring the deficiencies into compliance. LPA did not observe that any of the deficiencies have been brought to compliance.

Deficiencies are cited on the subsequent page of the report. Licensee was given a new Plan of Correction date of 08/19/2022. LPA explained that failure to correct the deficiencies within 10 day of the due date will result in a civil penalty. LPA verified Licensee's phone number and email.

Licensee’s annual fees were also discussed during today’s inspection.

Deficiencies are cited on the subsequent page of the report and pose a potential threat to the health and safety of children in care if not corrected.

This report was reviewed with licensee and an exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for 30 days.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 08/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 08/11/2022 04:49 PM - It Cannot Be Edited


Created By: Jeremey McClain On 08/11/2022 at 01:18 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
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: WADE, ERIN
FACILITY NUMBER: 313620616

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/19/2022
Section Cited
HSC
1596.8662(b)(1)

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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:
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Per the previous plan of correction dated 05/26/2022, licensee will complete the required training and send proof to LPA by the POC due date 08/19/2022.
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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:Licensee stated that she has not completed the training in order to clear the deficiency issued on 05/26/2022.
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Type B
08/19/2022
Section Cited
CCR102418(g)

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(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.This requirement is not met as evidenced by: Licensee stated that she has not completed children's immunization records in order to clear the citation issued on
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Per the previous plan of correction dated 05/26/2022,Licensee will document immunization's for children in care and send proof to LPA by the POC due date 08/19/2022.
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05/26/2022.
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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:Keven Peters
LICENSING EVALUATOR NAME:Jeremey McClain
LICENSING EVALUATOR SIGNATURE:
DATE: 08/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2022


LIC809 (FAS) - (06/04)
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