073404029-6-6-2023-02-CC-MPRE-CSJQ2N-20230606114727

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073404029
Report Date: 06/06/2023
Date Signed: 06/06/2023 11:47:35 AM

Document Has Been Signed on 06/06/2023 11:47 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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME:	DEL PRADO-EVANS, SHANNON		FACILITY NUMBER:	073404029
ADMINISTRATOR:	DEL PRADO-EVANS, SHANNON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 777-9115
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94531
CAPACITY:	14	CENSUS: 6	DATE:	06/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Shannon Del Prado-Evans		TIME COMPLETED:	11:47 AM

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 6/6/2023 at 9:30am Licensing Program Analyst (LPA) Morgan Pringle met with Licensee Shannon Del Prado-Evans for a Required – 1 Year Inspection. Present during the inspection was the Licensee, her husband N. Evans, her daughter/helper K. Evans and six (6) preschool age children. Licensee lives in the home with her husband and daughter K. Evans. The facility operates from 6:00am – 6:00pm, Monday - Friday. ON LIMITS AREA: Living Room, Kitchen, Dining Area, Family Room (Daycare Room), Downstairs Bathroom and Backyard OFF LIMITS AREA: Entire 2^nd Floor, Laundry Room, Downstairs Bedroom and Garage ISOLATION AREA: Family Room (Daycare Area) The facility is a two-story home rented by the Licensee. The inside of the home was observed to be neat, clean with ample age-appropriate materials for the children. All toxins, cleaning products, and hazardous materials were observed to be in inaccessible areas. All off-limit areas are made inaccessible with gates and locks. Licensee provides all food for the children. All food that is brought from the children’s home will be properly labeled and stored. Licensee stated they do not transport children. There are no pets and no firearms in the home.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

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: DEL PRADO-EVANS, SHANNON	FACILITY NUMBER: 073404029
	VISIT DATE: 06/06/2023

NARRATIVE

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The home has one (1) fully charged 3A40BC fire extinguisher and fire alarm on the wall next to the dining room table. There is one (1) working combination smoke/carbon monoxide detector and a stand-alone smoke detector in the hallway next to the downstairs bedroom. The home is equipped with central heat and air for proper ventilation. LPA observed all bedding is clean and in good condition. The fireplace in the living room is blocked by furniture making it inaccessible to the children in care. The stairs are gated making the staircase and the second floor inaccessible to the children in care. The backyard is fully fenced and well maintained with ample age-appropriate materials for the children. LPA did not observe any bodies of water in or around the home that could be a potential danger to the children in care.

Licensee’s Health and Safety training with has been completed. Licensee’s Pediatric CPR and First Aid training's are completed and expires 2/18/2024. Licensee’s Mandated Reporter training certificate is complete and expires 1/26/2024. Fire/disaster drills have been conducted with the last drill logged 5/25/2023. All adults living and working in the home have obtained a criminal record clearance. All required forms are posted and visible for public view in the living room of the home. LPA obtained a sample of the child’s files, facility files, and facility roster. All files were complete.

No deficiencies were cited during this inspection.

Licensee was reminded that California Law requires Licensee 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 624). Incidents must be reported within 24 hours by phone, fax, or email. The Licensee is reminded that any structural changes to the home or additions to the childcare facility must be reported to Community Care Licensing. Children’s Roster must be properly maintained, and fire/disaster drills must be conducted every six (6) months and documented. Licensee was reminded that EMSA approved Pediatric CPR & First Aid training must be completed every two (2) years. Licensee was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting http://www.mandatedreporterca.com. LPA informed Licensee that all forms can be downloaded at www.ccld.ca.gov.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

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: DEL PRADO-EVANS, SHANNON	FACILITY NUMBER: 073404029
	VISIT DATE: 06/06/2023

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) 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.

Licensee 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 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.

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.

A notice of site visit was given and must remain posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Exit interview conducted and report was reviewed with Shannon Del Prado-Evans.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 725-7009
LICENSING EVALUATOR NAME: Morgan Pringle	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

LIC809 (FAS) - (06/04)

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