153910654-1-21-2020-04-CC-JTHN-BL2QVX-20200121113103

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 153910654
Report Date: 01/21/2020
Date Signed: 01/21/2020 11:31:11 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	EVANS, DIANDRA FAMILY CHILD CARE		FACILITY NUMBER:	153910654
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	01/21/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Diandra Evans - Licensee		TIME COMPLETED:	11:45 AM

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An unannounced Annual/Random Inspection was conducted today by Licensing Program Analyst (LPA) Jessika Thompson. LPA with met with Licensee Diandra Evans and a census was taken. A tour of the facility was made; background clearances were discussed and reviewed. Licensee has current pediatric CPR and First Aid that expire on 08/25/20. Accessible areas of the home are the living room, dining room, kitchen, day-care room, and hallway bathroom. Off-limit rooms and/or areas are made inaccessible by spinning door knob covers and baby gates, which were observed to be in place by LPA on this date. Swimming pool is fenced per Title 22 regulations. Firearms and ammunition are properly stored. The home is clean and orderly, with heating and ventilation for safety and comfort. There are no stairs in this home. Safe, healthful, and comfortable accommodations, furnishings, toys and equipment were observed. There is a working telephone. Licensee has one cat that is accessible to children and one dog the inaccessible to children (occupies kennel when children are present). Licensee accepts full liability for any action taken by family pets. A current roster of children in care is maintained. LPA verified that immunization records are maintained, and licensee updates records for children in care. Licensee provides a copy of Parent’s Rights to all parents and/or child’s representatives. Licensee ensures that children in care are supervised at all times.

Fire and disaster drills are conducted at least once every six months, and documented with the date and time. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are stored where they are inaccessible to children. Facility has required fire extinguisher and smoke detector, both meet State Fire Marshall standards. Facility has functioning carbon monoxide detector that meets statutory requirements. Licensee understands children may not be left in parked vehicles. Safe sleep practices for infants was discussed and LPA provided the licensee with a handout. Lead safety was discussed, and Licensee stated she was aware of the policy therein. Licensee understands that lead safety information must also be provided to parents and/or authorized representatives of children in care.

(Continued on LIC809-C)

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: EVANS, DIANDRA FAMILY CHILD CARE	FACILITY NUMBER: 153910654
	VISIT DATE: 01/21/2020

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Provider Information Notices were discussed, and licensee is subscribed to receive updates via email. Licensee is aware that forms and updated information may be obtained on the Department's website (www.ccld.ca.gov). Licensee has proof of Child Abuse Mandated Reporter training, completed 10/17/18. Licensee is aware that this certification must be renewed every two years. Licensee understands that it is her responsibility to stay current with regulations. Licensee is urged to visit the U.S. Consumer Product Safety Commission web page at www.cpsc.gov to ensure that equipment purchased for the day care have not been recalled.

Incidental Medical Services (IMS) are not currently being provided. Licensee was advised that if/when any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Licensee was advised that the Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

Hours of operation are Monday through Friday from 7:00 AM to 5:30 PM and as arranged; less than 24 hours. Licensee is reminded of inspection authority by employees of the Department at any time, with or without advance notice.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found: (see LIC809-D)

In exit interview the licensee was advised of appeals rights and was provided with Appeals Rights. Licensee was also advised that this report with Type A Deficiencies must be posted for 30 days where parents may easily view and filed in facility file for public review for 3 years.

Licensee is advised to make this licensing report accessible to the public and to provide copies of this licensing report and LIC809-D with Type A citation to parents/legal guardians of children in care and to parents/legal guardians of children newly enrolled at the facility during the next 12 months. Licensee is to keep verification of receipt (LIC9224) in each child's file at the facility. An LIC9224 and Assembly Bill 633 fact sheet was provided to licensee on this date.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

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, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: EVANS, DIANDRA FAMILY CHILD CARE	FACILITY NUMBER: 153910654
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/21/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 01/31/2020 Section Cited	1 2 3 4 5 6 7	All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:Obtain a California clearance or a criminal record exemption as required by the Department. Violation of Section 102370(d) will result in a citation of a deficiency and an immediate assessment of civil penalties of one hundred dollars ($100) per violation per day for a maximum of five (5) days by the Department.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by LPA's observations & information obtained by LPA during records review. Today, LPA witnessed the licensee's grandmother, Eloise Brenstuhl, providing care to children within the family child care home(FCCH). During records review, LPA confirmed that Ms. Brenstuhl has undergone live scan; however, she has not obtained criminal record clearance, as the status of her background check is currently categorized as "pending". This poses an immediate health, safety, or personal rights risk to children in care. A civil penalty of $100.00 was assessed.	8 9 10 11 12 13 14	Until such time, Licensee was advised that Ms. Brenstuhl should not be providing care to children within the FCCH. If clearance is not obtained by 01/27/20, Licensee is to contact Licensing to inform LPA of her plan of action for Ms. Brenstuhl.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika Thompson	TELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2020

LIC809 (FAS) - (06/04)

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