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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313620616
Report Date: 06/02/2023
Date Signed: 06/02/2023 01:20:12 PM

Document Has Been Signed on 06/02/2023 01:20 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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
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:
06/02/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Erin WadeTIME COMPLETED:
01:40 PM
NARRATIVE
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Licensing Program Analyst (LPA) Jeremey McClain met with Licensee Erin Wade for an unannounced annual inspection.

LPA observed four preschool aged children. Licensee stated there aren’t new residents in the home. All individuals subject to criminal record review have obtained clearance. Licensee, Erin Wade, 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 toured areas of the home accessible to the children. The off-limit areas of the home were inaccessible.

Licensee stated that she does not have current CPR/First Aid Certification. LPA observed the following posted: a license, a Parents' Rights Poster and an Emergency Disaster Plan. LPA observed that licensee has current completion of AB1207 Mandated Reporter training expiring 08/18/2024. LPA provided Licensee with website: http://childcare.mandatedreporterca.com/ and reminded the licensee that the training must be completed once every two years.

LPA reviewed once children’s file for completeness. LPA observed a client roster. LPA observed records of immunizations for MMR, Pertussis, and influenza.

LPA observed that hazardous items (detergents, cleaning compounds, medication, sharp utensils, and other items that could pose a danger to children in care) are properly stored out of children's reach. LPA observed a fireplace that was properly screened.
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SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE: DATE: 06/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: WADE, ERIN
FACILITY NUMBER: 313620616
VISIT DATE: 06/02/2023
NARRATIVE
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LPA observed a working telephone in the home. Licensee stated that there are no weapons in the home. LPA observed a fire extinguisher and reminded licensee that they must be serviced at least once a year. Carbon monoxide and smoke detectors were tested and observed to be functional. LPA observed fire drills documented on a calendar, indicating that the licensee is conducting disaster drills at least once every 6 months. Equipment and furnishings in areas where children are active appeared to be safe and in working order. LPA did not observe any standing bodies of water during today’s inspection.

This facility does not currently provide Incidental Medical Services- IMS. 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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to [email protected]. 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/process.


Deficiencies were observed during today’s inspection and are cited on the following page of this report and pose a potential) threat to the health and safety of children in care.


This report was reviewed with licensee, and an exit interview was conducted. A Notice of Site Visit was provided and should remain posted for 30 days. (2/2)
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2023
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Document Has Been Signed on 06/02/2023 01:20 PM - It Cannot Be Edited


Created By: Jeremey McClain On 06/02/2023 at 01:13 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: WADE, ERIN

FACILITY NUMBER: 313620616

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 06/02/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above she did not have current completion of pediatric cardiopulmonary resuscitation and pediatric first aid, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/31/2023
Plan of Correction
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Licensee scheduled to recterify on 07/15/2023 during the inspection. Licensee will complete the class and provide proof to LPA by the POC due date 08/31/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: 06/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/02/2023


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