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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 070208696
Report Date: 04/19/2023
Date Signed: 04/19/2023 12:39:10 PM


Document Has Been Signed on 04/19/2023 12:39 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:KNIGHT, BEVERLYFACILITY NUMBER:
070208696
ADMINISTRATOR:KNIGHT, BEVERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 757-6864
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:12CENSUS: 1DATE:
04/19/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Beverly KnightTIME COMPLETED:
01:00 PM
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On 04/19/2023 at 10:30 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced annual inspection for Beverly Knight's large family child care home. LPA met with licensee and guided analyst on a tour of the facility. During today's inspection, there was 1 preschool aged child in care and 2 children enrolled. Licensee lives in the home. Licensee has Criminal Record Clearance. Facility hours of operations are Monday - Friday from 5:00 AM - 5:00 PM. Licensee states she cares for children ages 2-12 years old.

This is a one story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, attached garage, backyard with an fenced swimming pool and locked shed. Front yard has mounted play structure with swing set.
The children on limits areas: Hallway bathroom, kitchen, dining room, living room, backyard with fenced swimming pool and locked shed, front yard with mounted play structure with swing set.
Areas off limits include: All three bedrooms, master bathroom and attached garage.
The LPA toured all areas used by children during this visit.

Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and central heating system for safety and comfort. There were safe toys, play equipment and materials observed for children. There are no stairs in the home. There is a working telephone in the home. Detergents, poisons, cleaning compounds, medications, and other items which can pose a danger to children are made inaccessible in the home. Per licensee, there are no weapons or firearms in the home. Licensee has an up to code 3A40BC fire extinguisher and working smoke/carbon monoxide detector on the premises. LPA observed a screened fireplace in the living room. Licensee last conducted fire drill 03/2018. LPA reminded licensee of the importance and requirement to conduct fire drills. Licensee stated she will conduct fire drill and submit log to licensing. LPA observed 1 dog in the facility.

*CON'T ON PAGE 2*

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KNIGHT, BEVERLY
FACILITY NUMBER: 070208696
VISIT DATE: 04/19/2023
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*PAGE 2*

LPA inspected the backyard and observed a fully fenced and safe backyard for children in care. LPA observed a locked shed on the left side of backyard and on the right side, a fenced swimming pool that meets Title 22 regulations. Swimming pool is currently empty. In the front yard, LPA observed a mounted play structure with swing set as well as age appropriate toys for children to play with. LPA discussed with that there needs to be 100% supervision when children are playing on the play structure and in swimming pool. Licensee stated she takes children on nature walks around the city. LPA reminded licensee when outside of facility, 100% supervision of children in care is required. Facility does provide transportation for children, but licensee understands that children cannot be left alone, unattended in parked vehicles.

Children’s records were reviewed to ensure that each child has an Identification and Emergency form. LPA obtained a copy of facility child roster. The licensee Pediatric First Aid and CPR certificate expired in 05/2020. LPA reminded licensee the importance and requirement of having updated Pediatric First Aid/CPR certificate while having a child in care. Licensee stated she will update Pediatric First Aid/CPR certificate and submit certificate to licensing. Required postings were observed near the entrance.

LPA reminded licensee day care needs to be operated within the limitations and capacity of a Large Family Child Care Home with regards to ratios and that Licensee has to be present in the day care for 80% of the operation hours.


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.

CON'T ON PAGE 3*

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 2 of 7
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: KNIGHT, BEVERLY
FACILITY NUMBER: 070208696
VISIT DATE: 04/19/2023
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*PAGE 3*

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) Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

On or before March 30, 2018, any person who works in a child care facility shall complete Mandated Reporter training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. Licensee has provided Mandated Reporter certificate and the certificate expire 03/2018. LPA reminded licensee of the importance and requirement of maintaining an up to date Mandated Reporter certificate. Licensee stated she will update Mandated Reporter certificate and will submit certificate to licensing.


Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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/process

LPA Christina Watts informed Beverly Knight that this report dated 04/19/2023 documents a Type B citation. Type B citation(s) are a potential risk(s) to the health, safety, or personal rights of children in care.

*SEE LIC 809-D FOR DEFICIENCY. Exit interview conducted and report was reviewed with the licensee, Beverly Knight. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 04/19/2023 12:39 PM - It Cannot Be Edited

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: KNIGHT, BEVERLY
FACILITY NUMBER: 070208696

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/19/2023

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 observation and record review, the licensee did not comply with the section cited when licensee was caring for preschool aged child with an expired First Aid/CPR certificate which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/15/2023
Plan of Correction
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Submit First Aid/CPR certificate to licensing.
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: Sherelle JohnsonTELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina WattsTELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7