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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406092
Report Date: 01/26/2024
Date Signed: 01/26/2024 11:23:23 AM


Document Has Been Signed on 01/26/2024 11:23 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:PRINGLE, NINAFACILITY NUMBER:
073406092
ADMINISTRATOR:PRINGLE, NINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 755-9309
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY:14CENSUS: 4DATE:
01/26/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rachel PringleTIME COMPLETED:
11:30 AM
NARRATIVE
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On 01/26/2024 at 9:00 AM, Licensing Program Analyst (LPA) Sikia Blue conducted an unannounced annual inspection for Nina Pringle large family child care home. LPA met with licensee’s assistant Rachel Pringle and guided analyst on a tour of the facility. Licensee is home but just had surgery and was not physically able to participate during inspection today. During today's inspection, there were 4 children in care and 8 children enrolled. Present during inspection was licensee, licensee’s 3 employees who are also family members. Family members residing in the home have criminal background clearance. Facility hours of operations are Monday - Friday from 6:00 AM - 6:00 PM. Licensee’s aid states she currently cares for preschool and school aged children.

This is a two story home which consists of 5 bedrooms, 3 bathrooms, kitchen, dining room, office, living room, family room, laundry room, attached garage, and backyard.

The children on limits areas: kitchen, family room, downstairs bathroom, living room, and backyard.

Areas off limits include: upstairs 4 bedrooms, upstairs 2 bathrooms, downstairs bedroom, laundry room, office, 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 stairs in the home that are made inaccessible for children in care by a gate. 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 2A20BC 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 09/14/2023.

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SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Sikia BlueTELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2024
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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: PRINGLE, NINA
FACILITY NUMBER: 073406092
VISIT DATE: 01/26/2024
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*PAGE 2*

LPA inspected the backyard and observed a fully fenced backyard safe for children in care. LPA observed an ample supply of age-appropriate toys, equipment and furniture that appear to be safe and in good condition. LPA DID NOT observe any bodies of water. Licensee's aid stated she takes children to the local park for outdoor activity as well as uses the backyard. LPA discussed with 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. Personnel records were reviewed to ensure all employees’ files and certifications are up to date. Licensee’s Pediatric First Aid and CPR certificate will expire in 07/30/2024. 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.

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.

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SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Sikia BlueTELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: PRINGLE, NINA
FACILITY NUMBER: 073406092
VISIT DATE: 01/26/2024
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*PAGE 3*

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 11/15/2025.

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 violations observed.

Exit interview conducted and report was reviewed with the licensee’s aid, Rachael Pringle. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Sikia BlueTELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2024
LIC809 (FAS) - (06/04)
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