073408573-6-16-2021-02-CC-PPEN-C42REZ-20210616125823

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 073408573
Report Date: 06/16/2021
Date Signed: 06/16/2021 12:58:28 PM

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:	CALHOUN, CHERYSSE		FACILITY NUMBER:	073408573
ADMINISTRATOR:	CALHOUN, CHERYSSE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 917-8150
CITY:	EL SOBRANTE	STATE: CA	ZIP CODE:	94803
CAPACITY:	14	CENSUS: 11	DATE:	06/16/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Cherysse Cah		TIME COMPLETED:	01:00 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	Licensing Program Analyst (LPA) Paul Petersen visited this facility for an unannounced annual site inspection at 11:20AM. LPA met with licensee, Cherysse Calhoun, who was present along with licensee's daughters, Akayasha Calhoun and D'Asia Galathe, and assistant, Tamiko Johnson. There were eleven children in care including two infants and nine preschool age children. The facility is within capacity and all adults present are background cleared and associated to this facility. Children in care are being supervised. LPA and licensee toured the facility for a health and safety inspection. The on limits areas are the living room area (red rug room), the infant nap area (baby room), the family room (blue rug room) and the hall bathroom all located on the first floor of the facility. The entire upstairs is oof limits to children and there is safety gating at the base of the stairs. Off limits areas are made inaccessible by closed doors and visual supervision. The kitchen is off limits to children and there is child safety gating in place. There are no hazardous items/toxins observed to be accessible to children today. The fireplace is screened to prevent access. The facility has multiple working carbon monoxide detectors, working smoke detectors and a fully charged 2A10BC fire extinguishers. The back yard and sand play area is fully fenced and on limits to children in care. Outdoor play equipment is age appropriate and free of broken/sharp pieces. There are no pieces of high climbing equipment or swings present. There are no pools, hot tubs or other accessible bodies of water. Per licensee there are no firearms present or stored on the premises. Continued on Page 2*********************************************************************************

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 368-2672
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

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: CALHOUN, CHERYSSE	FACILITY NUMBER: 073408573
	VISIT DATE: 06/16/2021

NARRATIVE

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Children's files were reviewed for immunization records, identification and emergency information forms and parent's rights forms.

Facility records were reviewed for provider immunization records, mandatory reporter training certificates for all providers and the facility roster is current.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual-Regulation Interpretations and Procedures for Family Child Care Homes Sections 102417. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information 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

Safe Sleep regulation guidelines was provided along with LIC9227. Licensee is encouraged to visit www.ccld.ca.gov for licensing regulations and forms. Licensee is reminded that the mandatory reporter training is required to be renewed every two years for all providers of child care. To sign up for quarterly updates contact: childcareadvocatesprogram@dss.ca.gov.

There were no deficiencies cited during today's inspection. A notice of site visit was provided and is to be posted for 30 days. A copy of this report is to remain in the facility records and available for review for a period of three years from today's date.

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 368-2672
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

LIC809 (FAS) - (06/04)

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