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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 280106395
Report Date: 07/03/2019
Date Signed: 07/03/2019 11:34:08 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:MURRAY, CHERYL FAMILY CHILD CARE HOMEFACILITY NUMBER:
280106395
ADMINISTRATOR:MURRAY, CHERYL LYNNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 255-8631
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY:14CENSUS: 12DATE:
07/03/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:cHERYLTIME COMPLETED:
11:48 AM
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An annual inspection was made to the facility by Licensing Program Analyst (LPA) Kevin O'Connell. A review of staff records on 7/3/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are 2 adults living in the home. During today’s inspection the home and grounds were toured with the licensee at 10:42am. The licensee and one assistant were supervising 9 preschool children & 3 infants. Ratio/Capacity is met. Operating hours are 7:30am to 5:30pm Mon-Fri. Care is provided in the rear playroom and another room adjacent to this. A hallway bathroom is also used. Off limits areas are inaccessible by way of door knob covers.
The back yard is completely fenced and is used for outdoor play. The fireplace is screened and not used. Poisons are key locked in an backyard shed in an off limits area. The home was observed to be clean and orderly, and was at a comfortable indoor temperature.
There were safe toys and equipment available for children. There is a working telephone in the home. Items which could pose a danger to children (such as detergents, cleaning compounds, medications, etc.) were observed to be stored out of the reach of children. The LPA observed a working smoke detector, carbon monoxide detector and a charged fire extinguisher rated at least 2A:10-BC, in the home. The roster of children in care was reviewed and was current. The licensee had an emergency drill documented within the past six months (3/19). The licensee had current CPR and First Aid certifications that expire on 10/19.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
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,
, CA
FACILITY NAME: MURRAY, CHERYL FAMILY CHILD CARE HOME
FACILITY NUMBER: 280106395
VISIT DATE: 07/03/2019
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Licensee stated that there are no guns or dangerous weapons on the premises and none were observed.
Seven children's records were reviewed at 10:50am. Immunizations and signed Notification of Parent’s Rights forms were on file. Two staff files were reviewed (at 10:55am) for immunizations and Mandated Reporter Training certificates and were complete.
The Incidental Medical Services (IMS) policy was discussed with the licensee. The licensee is not providing Incidental Medical Services (IMS) to children in care. 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 is provided: US Department of Justice 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, www.ada.gov/childqanda.htm.

This report, as well as the AAP Guide to Safe Sleep, Safe Sleep in Childcare brochure, What does a Safe Sleep Environment Look Like brochure & Safe Sleep Concepts handout, were reviewed and discussed with the licensee. The Effects of Lead Exposure brochure has been reviewed with and discussed with the licensee.

All licensing reports are public information and must be made available upon request for at least three years.
Notice of Site Visit shall be posted for 30 days from today's visit.
Failure to keep this notice posted for 30 days may result in a civil penalty of $100.
No deficiencies were cited today.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
LIC809 (FAS) - (06/04)
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