073402647-12-14-2022-02-CC-CWAS-CM4VNL-20221214153519

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073402647
Report Date: 12/14/2022
Date Signed: 12/14/2022 03:35:34 PM

Document Has Been Signed on 12/14/2022 03:35 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:	MCGLOTHIN, ANGELA		FACILITY NUMBER:	073402647
ADMINISTRATOR:	MC GLOTHIN, ANGELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 755-2925
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94509
CAPACITY:	14	CENSUS: 3	DATE:	12/14/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Angela McGlothin		TIME COMPLETED:	04:45 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 12/14/2022 at 1:30 PM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced annual inspection for Angela McGlothin's family child care home. LPA met with licensee and guided analyst on a tour of the facility. During today's inspection, there were 3 children in care(1 infant and 2 preschool aged children) and 3 children enrolled. Licensee was the only adult in the home during inspection. Family members residing in the home are licensee, licensee spouse, licensee's 16 year old child and licensee's adult child. Facility hours of operations are Monday - Friday from 6:00 AM - 6:00 PM. Licensee, Licensee's husband, licensee 3 adult children are fingerprint cleared. During record review, it was discovered that licensee's adult child who lives in the home currently does not have a criminal background clearance nor is associated to the facility. LPA did not observe adult child in the home during inspection. LPA informed licensee that adult child is required to have fingerprint clearance in a family child care home. This is a two story home which consists of 4 bedrooms, 3 bathrooms, kitchen, dining room, living room, family room, laundry room, attached garage, and backyard. The children on limits areas: Living Room, Family Room, Kitchen, Dining room, first floor bathroom and backyard. Areas off limits include: Entire second floor which includes 4 bedrooms and 2 bathrooms , laundry room and attached garage. The LPA toured all areas used by children during this visit. 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 family room. Licensee last conducted fire drill 12/05/2022. Licensee stated there are not pets in the home. *Con't on page 2*

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: MCGLOTHIN, ANGELA	FACILITY NUMBER: 073402647
	VISIT DATE: 12/14/2022

NARRATIVE

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*Page 2*

LPA inspected the backyard and observed a basketball hoop. Licensee stated she uses a park nearby the facility for outdoor activity. LPA discussed with that there needs to be 100% supervision when children are playing in the backyard and when outside of the facility.

Licensee does provide transportation for children and 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. Licensee stated she was unaware of the requirement to log sleep for infant in care. LPA informed licensee about Safe Sleep regulations. Licensee stated she will start a sleep log for infant in care. The licensee Pediatric First Aid and CPR certificate will expire in 10/2024. Child Roster was reviewed and a copy obtained. 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.

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 stairs in the home that are made inaccessible for children in care. 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.

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 Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: MCGLOTHIN, ANGELA	FACILITY NUMBER: 073402647
	VISIT DATE: 12/14/2022

NARRATIVE

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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 will expire 03/2023.

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

In the areas that were evaluated, there were no violation observed.

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

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2022

LIC809 (FAS) - (06/04)

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