013423524-6-16-2021-02-CC-DCAS-C42QVY-20210616123107

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 013423524
Report Date: 06/16/2021
Date Signed: 06/16/2021 12:31:12 PM

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	THORNTON, MONTRAE		FACILITY NUMBER:	013423524
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	06/16/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Montrae Thornton		TIME COMPLETED:	12:45 PM

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	On 06/16/2021 at 9:00am, Licensing Program Analyst (LPA) Diana Campos arrived at the home for an unannounced 1 year required inspection. LPA met with the licensee Montrae Thornton. The licensee's fiance who assists with day care, and 6 children were also present during today's inspection. At 9:30am, LPA toured the areas of the home used for child care with licensee to conduct a health and safety inspection. The home is a one story home, which is neat and clean with heating and ventilation for the safety and comfort of children in care. The on limit areas include the living room, dining room, kitchen, both rooms in the hallway next to the bathroom which serve as activity rooms and the bathroom in the hallway. The off limit areas include the bedroom and bathroom located near the back door, and the garage. These areas are made inaccessible by gate, closed and/or locked doors and visual supervision. The isolation area will be the room to the left of the bathroom in the hallway, away from other children in care. LPA observed an ample supply of toys and activities accessible to children in care, and they are age appropriate and in good condition. There is a gate at the front door to prevent access to children to the stairs leading to the front door of the home. The outdoor play area is the fenced backyard, which is free from defects or dangerous conditions. There is a working smoke detector, carbon monoxide detector, telephone, first aid supplies and a fully charged 3 A 40 BC fire extinguisher. Per the licensee, there are no firearms in the home. The heating vents are on the floor and do not become hot to touch. The fireplace in the living room is blocked, to prevent access by children. LPA did not observe any bodies of water, hazardous items, or toxins accessible to children during today's inspection. At 10:30am, LPA reviewed the files of 3 children in care. The licensee's CPR/first aid certificates are current and expire on 05/28/2023. The facility roster was reviewed and a copy obtained. ------------------------------------------------------- continued on 809-C

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

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

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: THORNTON, MONTRAE	FACILITY NUMBER: 013423524
	VISIT DATE: 06/16/2021

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
26
27
28
29
30
31
32

The licensee has a certificate of completion for the required mandated reporter training, completed on 5/26/2021. Licensee was reminded of responsibility as a mandated reporter.
Licensee was encouraged to frequently visit our website at www.ccld.ca.gov for licensing regulations and updates, and to sign up to receive quarterly updates by email by sending a request to ChildCareAdvocatesProgram@dss.ca.gov.

Incidental Medical Services (IMS) policy was discussed. The licensee stated that there are no children enrolled at this time, who require medication while in care.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. LPA reviewed the individuals associated to the license, and the licensee confirmed that everyone who is required to have a criminal record clearance is associated.

LPA provided licensee with a copy of the Child Care Provider's Guide to Safe Sleep brochure for a reference if needed in the future. Licensee was advised of new Title 22 Regulations regarding Safe Sleep.

Licensee left for an appointment but consented for assistant Maria Hall to sign reports.

There are no deficiencies being cited today. This report shall remain on file for 3 years. A Notice of Site visit was given to assistant Maria Hall, and assistant was reminded that it is required to be posted for 30 days. An exit interview was conducted with assistant Maria Hall.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana Campos	TELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2