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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073406608
Report Date: 06/08/2023
Date Signed: 06/08/2023 06:03:59 PM


Document Has Been Signed on 06/08/2023 06:03 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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:HORNER, CHERIFACILITY NUMBER:
073406608
ADMINISTRATOR:HORNER, CHERIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 813-0853
CITY:ANTIOCHSTATE: CAZIP CODE:
94531
CAPACITY:14CENSUS: 4DATE:
06/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:23 PM
MET WITH:Cheri HornerTIME COMPLETED:
06:15 PM
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On June 8, 2023, at 2:23 PM, Licensing Program Analysts (LPAs) Lorraine Dacanay Breaux and Jaleesa Jackson met with licensee Cheri Horner for an Unannounced Required 1 Year Inspection. LPA disclosed the purpose of the inspection and was granted entry into the facility by the licensee. Present during the inspection were three preschool age children and one infant (18 months). Licensee stated that the facility operates from Monday to Friday 7:30 AM to 5:30 PM.

LPA toured the facility inside and outside to conduct a Health and Safety inspection. This single story home was clean and orderly, with heating and ventilation for the safety and comfort of children in care. Four bedroom home, 2.5 bathrooms with livingroom, dining room, kitchen, family room and 3 car garage. .

ON-LIMIT AREAS: the living room, dining room, family room, half bathroom near the entry, kitchen and rear yard.


OFF-LIMIT AREAS: the master bedroom and bathroom, all bedroom, laundry room, three car and garage. The off limits areas will be inaccessible to children by locked doors, safety gates and visual supervision. The OUTDOOR PLAY area is the fully fenced backyard and LPA observed that it is free from defects or dangerous conditions. During today's inspection, there are play structures which are required to be anchored. There are ample age appropriate toys that appear to be safe and in good condition. There's a small play structure with swings that is anchored. The Isolation area of the home will be a section of the family room, away from other children in care.

Per licensee request, removed the two bedrooms from on limits to off limits. Added the family room to on limits.

There was a hot tub in the rear yard, has a four locks with a key, small fence to keep the children away from the area. LPA reminded licensee to ensure the hot tub is locked during business hours. LPA did not observe any hazardous materials or toxins accessible to children during today’s inspection.

See 809-C for continuance

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:
DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/08/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: HORNER, CHERI
FACILITY NUMBER: 073406608
VISIT DATE: 06/08/2023
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At 3:30 PM LPA requested and reviewed the files of two (2) children in care. All children files contain Immunization, Parent's Rights, and Medical Consent forms. The facility roster was reviewed, and copies were obtain. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on 04/25/23. The licensee's Health and Safety training is completed, and CPR and First Aid certificate is current and expires 05/2025. The licensee is in compliance with the immunization laws which pertains to all childcare providers. All required forms are posted and visible for public review. The licensee was reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care.

Licensee informed LPAs that she does provide transportation, LPAs reviewed drivers licenses and auto insurance is valid. LPAs inspected the van, seat belts and car seat are operable.

Effective August 1, 2003 California Law requires Family Child Care Home licensees 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 624B). Incidents must be reported within 24 hours by phone, fax, or electronic mail. LPA informed the licensee that all forms can be downloaded at www.ccld.ca.gov and encouraged the licensee to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The licensee was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

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

809-C

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023
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
BAY AREA-CC OAKLAND, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: HORNER, CHERI
FACILITY NUMBER: 073406608
VISIT DATE: 06/08/2023
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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.

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.

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/inspection-process.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights provided. Exit interview conducted and report was reviewed with the licensees, Cheri Horner.

SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2023
LIC809 (FAS) - (06/04)
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