293623985-8-6-2021-03-CC-BMOS-C5MNVJ-20210806104802

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 293623985
Report Date: 08/06/2021
Date Signed: 08/06/2021 10:48:07 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:	DYKES, SHARON		FACILITY NUMBER:	293623985
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	08/06/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Sharon Dykes - Licensee		TIME COMPLETED:	11:00 AM

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	On Friday, August 6th, 2021, at 10:14am, Licensing Program Analyst (LPA) Blake Morillas conducted a Case Management visit for the purpose of increasing capacity from 8 to 14 children. The Fire Safety Inspection Clearance has been received and the home has been cleared for up to 14 children. At 10:14am LPA informed the Licensee, Sharon Dykes, of the reason for the inspection. At 10:14am, 1 infant and 2 preschool age children were observed along with the Licensee and her helper. Licensee stated there are no new residents in the home. Adult residents have criminal record clearances. At 10:16am, LPA initiated a health and safety inspection of all areas accessible to children. Off-limits areas will continue to include the Master Bathroom and Garage. Licensee acknowledged that children may never enter these off-limit areas. LPA observed current CPR/First Aid certificate (expires: 6/2023), posted License, Parent's Rights and current emergency disaster plan. A current roster of the enrolled children and fire drill log was observed. Hazardous items were stored inaccessible to children in care. Licensee noted that at this time there are no weapons in the home. However two safes have been installed to ensure Firearms are stored in their own safe and ammunition is separately stored according to Title 22 Regulations. Fire extinguisher (2A10BC), carbon monoxide and smoke detector meet regulation. Toys appear to be safe. 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: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

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: DYKES, SHARON	FACILITY NUMBER: 293623985
	VISIT DATE: 08/06/2021

NARRATIVE

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Continued from LIC 809

The outdoor area used by children is a semi-fenced back yard with a deck, and an unfenced front yard. Licensee understands that 100% supervision is required when children are using any of the yards or deck.

There are no bodies of water on the premises.

Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

Capacity increase is approved as of 8-6-2021.

The facility is licensed to serve a MAX. CAP(WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

At 10:45am, LPA reviewed and discussed this facility evaluation report with the Licensee.

Notice of site visit will be posted.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 08/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021

LIC809 (FAS) - (06/04)

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