073404903-2-24-2023-02-CC-CWAS-CPCSCB-20230224124515

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073404903
Report Date: 02/24/2023
Date Signed: 02/24/2023 12:45:33 PM

Document Has Been Signed on 02/24/2023 12:45 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:	HOLMES, SHARON		FACILITY NUMBER:	073404903
ADMINISTRATOR:	HOLMES, SHARON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(925) 864-4045
CITY:	ANTIOCH	STATE: CA	ZIP CODE:	94509
CAPACITY:	14	CENSUS: 0	DATE:	02/24/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Sharon Holmes		TIME COMPLETED:	12:40 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 02/24/2023 at 9:40 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced annual inspection for Sharon Holmes's large family child care home. LPA met with licensee and guided analyst on a tour of the facility. During today's inspection, there were no children in care and 1 preschool child enrolled. Licensee stated preschool child is currently attending on a part time basis. Licensee stated she does not care for children on a regular basis. Family members residing in the home are licensee, licensee's daughter, licensee's daughter in law and licensee's 5 grandchildren ( 4 minor grandchildren and 1 adult grandchild). Facility hours of operations are Monday - Friday 7:00 AM - 4:30 PM. 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, Dining Room, Kitchen, Family Room and backyard Areas off limits include: All of the second floor which includes 4 bedrooms, 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 3A40BC fire extinguisher that needs to be recharged. Licensee stated she needs plans to recharge the fire extinguisher. LPA observed a working smoke/carbon monoxide detector on the premises. LPA observed a screened fireplace in the family room. Licensee last conducted fire drill in 2016. Licensee stated she will conduct fire drill and submit log to licensing. Licensee stated she does have any pets in the home. LPA inspected the backyard and observed a fenced and safe backyard. Licensee stated she uses nearby park for outdoor activity. LPA reminded licensee when outside of facility, 100% supervision of children in care is required. Facility does not provide transportation for children, but understands that children cannot be left alone, unattended in parked vehicles. *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: 02/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

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: HOLMES, SHARON	FACILITY NUMBER: 073404903
	VISIT DATE: 02/24/2023

NARRATIVE

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*PAGE 2*

Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The licensee Pediatric First Aid and CPR certificate is currently expired. Licensee stated she was enrolled in the CPR/First Aid certificate course but had to disenrolled. Licensee stated she has now enrolled in CPR/First Aid course. LPA required licensee complete CPR/First Aid 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.

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.

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. *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: 02/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

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: HOLMES, SHARON	FACILITY NUMBER: 073404903
	VISIT DATE: 02/24/2023

NARRATIVE

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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 stated she did not update her Mandated Reporter certificate. Licensee stated she will update the Mandated Reporter certificate and 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

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

Exit interview conducted and report was reviewed with the licensee, Sharon Holmes. 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: 02/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

LIC809 (FAS) - (06/04)

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