330928257-1-6-2023-09-CC-GCAO-CMTPD3-20230106101251

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 330928257
Report Date: 01/06/2023
Date Signed: 01/06/2023 10:13:13 AM

Document Has Been Signed on 01/06/2023 10:13 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	HOWARD FAMILY DAY CARE		FACILITY NUMBER:	330928257
ADMINISTRATOR:	HOWARD, B		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(951) 347-0737
CITY:	RIVERSIDE	STATE: CA	ZIP CODE:	92504
CAPACITY:	14	CENSUS: 8	DATE:	01/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Bonnie Howard		TIME COMPLETED:	10:25 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 01/06/2023 at 8AM Licensing Program Analyst (LPA) Giselle Carbullido arrived at the facility to conduct an annual inspection. LPA was granted entry by Licensee, Bonnie Howard. LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: Normal days and hours of operation are: Monday through Friday, 5:45am to 6:30pm OFF-LIMIT AREAS INCLUDE: Three bedrooms and garage During tour of facility at 8:15AM LPA observed off limit room used for sleeping infant. · The inspection consisted of reviews of the following domains: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio and Capacity, and Personal Rights The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. Deficiencies cited this visit; and technical advisories were given. · The facility is operating within the licensed capacity and appropriate ratios · Appropriate supervision provided during visit · A working telephone is present · Appropriate fire extinguisher present; carbon and smoke detectors operational and tested by Licensee · The fireplace is properly screened and facility is a single story home. · The facility is clean and orderly and has adequate heating and ventilation for safety and comfort · All hazardous items inaccessible to children and toxins are locked · Per Licensee, no guns or weapons present. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations · Outdoor play area is fenced, or appropriate supervision is present · Clean, safe and age appropriate toys for indoor and outdoor activity

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: HOWARD FAMILY DAY CARE	FACILITY NUMBER: 330928257
	VISIT DATE: 01/06/2023

NARRATIVE

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No bodies of water at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.

· Pediatric CPR and First Aid Card expire 03/2024

· Health & Safety Certificate - Licensee is updating for Nutrition and Lead components
· Mandated reporter: Child Care Expires: 03/2023 Fire clearance: 02/04/2000
Facility Sketch, Emergency Disaster Plan, License & Notification of Parent’s Rights are posted Current roster on file: yes Documentation of fire drills on file - Last drill: 10/20/2022 Verification of control of property Children’s records are complete Employee’s records are not complete. Assistant does not have mandated reporter; see LIC9102 technical advisory

· To receive important licensed- related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

· 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 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

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: HOWARD FAMILY DAY CARE	FACILITY NUMBER: 330928257
	VISIT DATE: 01/06/2023

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There is a children's trampoline on the premises and the licensee states that it is used by children in care. The trampoline and its surrounding cover appear to be in good repair with no tears or exposed springs. The manufacturer of the trampoline is My 1st trampoline and the licensee does not have manufacture guidelines. The licensee agrees to provide adequate supervision to all children in care when in use.

· Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
· LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
· To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
· A notice of site visit was given and must remain posted for 30 days.
· Exit interview conducted and report was reviewed with the licensee Bonnie Howard.

SUPERVISOR'S NAME: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/06/2023 10:13 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: HOWARD FAMILY DAY CARE	FACILITY NUMBER: 330928257
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/06/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416.3(a)(6)

Alterations to Existing Building or Grounds

(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation), the licensee did not comply with the section cited above in that upon arrival and during tour of facility LPA observed infant in off limit room sleeping. which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/09/2023
	Plan of Correction
1 2 3 4	Licensee will remove crib and place in on limit room by POC due date 01/09/2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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: Gilbert Sena	TELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle Carbullido	TELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2023

LIC809 (FAS) - (06/04)

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