293623926-5-10-2021-03-CC-BMOS-C2VPYX-20210510114441

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293623926
Report Date: 05/10/2021
Date Signed: 05/10/2021 11:44:50 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME:	MCKNIGHT, RACHAIEL		FACILITY NUMBER:	293623926
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	05/10/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:02 AM
MET WITH:	Rachaiel McKnight		TIME COMPLETED:	12:00 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	*NOTE: Due to Covid-19 and DPH guidelines on social distancing, a Tele-inspection was conducted via FaceTime.* On Monday, May 10th, 2021, at 10:02am, Licensing Program Analyst (LPA) Blake Morillas began a tele-inspection with Applicant, Rachaiel McKnight, for a Prelicensing inspection. This is a two story, 3 bedroom, 2.5 bathroom home. The anticipated operating hours will be 7:30am to 5:00pm, Monday through Friday, and will operate year round. At 10:05am, LPA initiated a health and safety tele-inspection with the help of the Applicant of all areas of the home as well as the outdoor area that will be used by the children in care. Off-limits areas will include the Master Bedroom, Upstairs Bathrooms, Office, Kitchen, Garage, Front Yard. Applicant acknowledged that children may never enter these off-limit areas. The entryway of the home consists of a tiled area with two steps leading down to the living room. The Applicant was asked to limit the time the children were on the tiled area to only drop off and pick up times as well as to have 100% supervision of the children when they are on the tiled entryway. There are stairs in the home which have been properly gated and both the top and bottom. There is also a fireplace in the home that has been appropriately barricaded as well. *PAGE 1 of 3 - Continued on LIC 809-C

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2021

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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: MCKNIGHT, RACHAIEL	FACILITY NUMBER: 293623926
	VISIT DATE: 05/10/2021

NARRATIVE

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*PAGE 2 of 3 - Continuation of LIC 809

Carbon monoxide and smoke detectors meet regulation. Hazardous cleaning compounds and medications are stored inaccessible and out of reach of children. Applicant noted at this time there are no firearms in the home.

The outdoor area used by children will consist of a fenced porch and semi fenced backyard play area. Applicant understand that 100% supervision is required while the children are using the fenced porch as well as when occupying unfenced areas. Age appropriate toys were observed.

At 10:30am, LPA began to review Children’s files and other documentation that is required for operation of a day care. Applicant rents the home and provided the appropriate forms. LPA reviewed the fire drill requirements.

At this time, the Applicant does not carry liability insurance. LPA explained about obtaining a $300,000 annual aggregate/$100,000 per occurrence liability insurance policy. Applicant understands that until a policy is obtained, they must use the affidavit.

All adult residents received criminal record clearances. LPA reminded Applicant of the applicable Civil Penalty per person for those adults, including your own children, who have not received fingerprint clearances.

The Applicant has completed Mandated Reporter Training. The Applicant also completed CPR/First Aid training at time of application (exp: 4/2023).

LPA provided the Lead Testing brochures (AB 2370), went over the recently implemented Infant Safe Sleep Regulations, as well as went over the current guidelines in operating during the Covid-19 Pandemic. A completed Covid-19 Self Assessment will be sent to the LPA once completed by the Applicant.

*Continued on LIC 809-C

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2021

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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: MCKNIGHT, RACHAIEL	FACILITY NUMBER: 293623926
	VISIT DATE: 05/10/2021

NARRATIVE

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*PAGE 3 of 3 - Continuation of LIC 809-C

Incidental Medical Services (IMS) policy was discussed. 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 are available online (www.ada.gov/childqanda.htm). Applicant was encouraged to visit the Department website (ccld.ca.gov) for child care updates, current forms, legislation and regulation information. LPA advised the Applicant of their responsibility to stay current with the requirements of the Department.

At 11:30am, LPA reviewed and discussed this facility evaluation report with the Applicant. The Applicant was informed that when a physical inspections takes place, requests for alterations may be made.

Effective today (5-10-2021) the facility is PROVISIONALLY LICENSED (Expires 8-10-2021) to serve a MAX. CAP: 6 - NO MORE THAN 3 INFANTS OR 4 INFANTS ONLY. CAP 8 - NO MORE THAN 2 INFANTS, 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

The following item is to be submitted prior to expiration of the Provisional License and prior to final approval of license:
* Certificate of Completion of Preventive Health and Safety Training.

This report and a Notice of Site Visit will be delivered to the Applicant electronically. Acknowledgement of delivery will constitute acknowledgement of the report in lieu of a signature.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2021

LIC809 (FAS) - (06/04)

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