013416649-3-3-2022-52-CC-LDBX-CC6QZD-20220303113634

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013416649
Report Date: 03/03/2022
Date Signed: 03/03/2022 11:36:57 AM

Document Has Been Signed on 03/03/2022 11:36 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	SUTTON, PATRICIA		FACILITY NUMBER:	013416649
ADMINISTRATOR:	SUTTON, PATRICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 846-4116
CITY:	PLEASANTON	STATE: CA	ZIP CODE:	94566
CAPACITY:	14	CENSUS: 8	DATE:	03/03/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Patricia Sutton		TIME COMPLETED:	11:55 AM

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On March 3, 2022 at approximately 8:30 AM Licensing Program Analyst (LPA) Lorraine Dacanay Breaux and LPM Chandra Charles met with licensee Patricia Sutton for the purpose of conducting an unannounced 1-year annual inspection. Living in the home is the licensee, her fingerprint cleared and TB tested husband and son. Present in the home for today’s inspection was the licensee's fingerprint cleared assistant who is her son, Benjamin Sutton, 8 (eight) children were in care. The hours of operation will be Monday- Friday, 7:00 AM to 6:00PM

The facility is a 2 story, 5 bedroom, 3.5 bathroom home. This home consist of living room, family room (screened fire place), dining room, kitchen, garage and front and back yard areas. The home has heating and ventilation for safety and comfort. Per the licensee, the ISOLATION AREA will be in the on limits family room away from the other children in care. Licensee uses the local park at the rear of home, walk around to the park (not using the path and/or rear gate of the pool area).

On-limit-areas include: on main level bedroom (child care room), family room, kitchen (travel through) and bathroom in the bedroom (child care room). Front and rear yard both gated. There is a pellet stove in the family room that is inaccessible to children in care.

Off-limit-areas include: Main level the half bathroom, living room (right of the entrance), dining room, kitchen, and the second level which includes the master bedroom and 2 bathrooms, 4 bedrooms. Off-limit areas will be inaccessible by closed and/or locked doors, child gates and/or by supervision.

The home has a pool that has a self latching and self closing gate and inaccessible to children. There is a firearm in the home which is stored in the locked cabinet. The ammunition is locked and stored separately. Detergents, cleaning compounds, medications and other items which could pose a danger to children are stored and inaccessible to children. Stairs are gated. Licensee has ample age-appropriate toys and learning materials inside and outside that were observed to be safe and in good condition. The home has a fully charged 3 A40BC fire extinguisher. Smoke detector, carbon monoxide detector and a working telephone.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SUTTON, PATRICIA	FACILITY NUMBER: 013416649
	VISIT DATE: 03/03/2022

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LPA requested and reviewed the files of 8 (eight) children in care. All files contained Immunization, Parent's Rights, and Medical Consent forms. The facility roster was reviewed, and copies were obtain. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on February, 2022. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires 09/12/2023. The licensee is in ratio today. All required forms are posted and visible for public review.

LPA reminded licensee of the following: Mandated Reporter training is to be renewed every two years; CPR/First Aid is also renewed every two years. Baby bouncers & drop-down cribs are not allowed at the day-care facility. The licensee is reminded any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing.

California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

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 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-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SUTTON, PATRICIA	FACILITY NUMBER: 013416649
	VISIT DATE: 03/03/2022

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Licensee [or facility representative] 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.

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 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.

Licensee was given a technical violation in regards to not having mandated reporter training completed for self and staff. Must be completed by March 17, 2022.

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

SUPERVISOR'S NAME: Chandra Charles	TELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

LIC809 (FAS) - (06/04)

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