334845859-4-21-2021-09-CC-DHOE-C2AKLE-20210421075949

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334845859
Report Date: 04/15/2021
Date Signed: 04/21/2021 08:00:22 AM

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:	COMBS FAMILY CHILD CARE		FACILITY NUMBER:	334845859
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	04/15/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	05:26 PM
MET WITH:	Licensee, Faith Combs		TIME COMPLETED:	06:30 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	Due to COVID-19 State of Emergency, on 04/15/2021 at 05:26pm, Licensing Program Analyst (LPA) Destinee Hogue conducted a case-management Licensee initiated tele-inspection with Licensee, Faith Combs via FaceTime. The Licensee has applied to increase her capacity to that of a Large Family Child Care Home. A fire clearance was granted on 03/24/2021. Present during this tele-inspection were; Licensee, LPA and Licensee's minor child, there were no daycare children present at the time of this tele-inspection. LPA Hogue toured the facility, inside and outside, records were reviewed, and the following was observed and discussed with Licensee: Normal days and hours of operation are: Monday – Friday, 6:00am to 6:00pm OFF-LIMIT AREAS INCLUDE: Bedroom #1, Bathroom #2, Bedroom #3, hallway closet, Laundry Room, Small and Big Garage, Rear Yard (BBQ & Storage area), and Pool. -The primary care facility (activities, meals, and napping) will be the kitchen, living room, Bedroom #2, Bedroom #4, Bathroom #1, front yard (front yard is fenced and kept locked during daycare hours), and backyard (small driveway, basketball court, back grass/dirt patch). · Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the Licensee during this tele-inspection. · All hazardous items were made inaccessible, at this time. · Toxins and poisons were locked, at this time. · No guns or weapons present as of this date. LICENSEE UNDERSTANDS ALL GUNS, WEAPONS AND AMMUNITION MUST BE KEY-LOCKED SEPARATELY AND MADE INACCESSIBLE PER TITLE 22 REGULATIONS. · Facility is a single-story residence · There is no fireplace at the facility.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2021

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

FACILITY NAME: COMBS FAMILY CHILD CARE	FACILITY NUMBER: 334845859
	VISIT DATE: 04/15/2021

NARRATIVE

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· Verification of control of property on file (Mortgage statement)
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights forms are posted
· Pediatric CPR and First Aid Card expires on 11/30/2022
· AB1207 Mandated Child Abuse Reporter Training Certificate completed on 04/22/2020
· The fence surrounds the entire pool, the gate is self-closing, self-latching, the gate opens away from the pool. The opening between railings does not exceed 4 inches. The bottom of fence is no more than 4” from the ground on the hard surface. No window or door provides direct access to the pool. 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.
· Clean, safe and age appropriate toys
· There are no toxic plants observed at this time.
· Current roster on file
· Documentation of fire/emergency disaster drills on file. Last fire/emergency drill conducted on 03/18/2021.
· Children’s records are complete
· Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed.
Resident and/or staff records reviewed on 04/15/2021 indicate that all adults who require caregiver background checks have received all required clearances or exemptions.
· The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations862@dss.ca.gov
· The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov
· Incidental Medical Services (IMS) policy was discussed. 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: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2021

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: COMBS FAMILY CHILD CARE	FACILITY NUMBER: 334845859
	VISIT DATE: 04/15/2021

NARRATIVE

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· For more information on SIDS and Safe Sleep Environments, please visit:
California Department of Public Health – California SIDS Program: http://www.cdph.ca.gov/programs/SIDS/pages/default.aspx
AAP – Safe Sleep Campaign: http://www.healthychildcare.org/sids/html
AAP-Free Training: Reducing the Risk of SIDS in Early Education and Child Care: http://shop.aap.org/Reducing-the-Risk-of-SIDS-in-Early-Education-and-Child-Care
And Caring for our Children, Safe Sleep Practices and SIDS/Suffocation Risk Reduction: http://cfoc/nrckids/org/standardview/spccol/safe_sleep

The following was reviewed with the licensee(s):
- SB 277 – Immunizations, Personal Beliefs Exemption, effective January 1, 2016: See LIC809-Facility Evaluation Report dated 0623/2020 for further information on SB277.
- AB290 – Child Nutrition, effective January 1, 2016: See LIC809-Facility Evaluation Report dated 0623/2020 for further information on SB277.
- SB792 – Immunization requirements for staff, volunteers, effective September 1, 2016: See LIC809-Facility Evaluation Report dated 0623/2020 for further information on SB277.
- AB2231 (2016) – Increased Civil Penalties, effective July 1, 2017: See LIC809-Facility Evaluation Report dated 0623/2020 for further information on SB277.
- AB 1207 – Mandated Child Abuse Reporting: Child Day Care Personnel Training, beginning January 1, 2018 – In accordance with California Health and Safety Code Section 1596.8662 – requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Applicants must meet requirements as a precondition to licensure. Existing licensees must meet requirements by March 30, 2018. New employees shall have 90 days to complete training as required. This training requirement may be directly met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/ and are provided in English and Spanish. If no training is made available in a required person’s primary language then those persons shall be exempt from this requirement
- AB2370 – Effective January 1, 2019 – Lead Poisoning – providers are required to provide a lead toxicity prevention handout to parents/guardians of newly enrolled and newly reenrolled children with information on risks and effects of lead poisoning; blood lead testing recommendations and requirements; and options for obtaining blood lead testing, including free and/or discounted testing. There will be a training component of this added to the Preventative Health Training beginning July 1, 2020.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2021

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: COMBS FAMILY CHILD CARE	FACILITY NUMBER: 334845859
	VISIT DATE: 04/15/2021

NARRATIVE

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- Effective January 1, 2017 – Children under 2 years of age shall ride in a rear-facing car seat unless the child weighs 40 or more pounds OR is 40 or more inches tall. For additional information regarding car seat laws see www.chp.ca.gov

- Access to forms & Regulations for Family Child Care Homes online at www.cdss.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility’s phone numbers must be on file at all times.
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The Licensee is urged visit the U.S. Consumer Product Safety Commission webpage at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled
- The Duty Officer is available to answer questions Monday – Friday at (951)782-4200.

The application for a Large Family Child Care Home will be submitted for approval with a maximum capacity of 12, or 14 with parent notification.

Due to COVID-19 State of Emergency, LPA Hogue conducted an exit interview with Licensee via FaceTime and provided an email copy of this report to the Licensee. LPA requested the Licensee to acknowledge receipt of the email by replying to the sent email. The electronic response from the Licensee, will serve as the read receipt of the emailed report.

Licensee understands that a copy of this report must be made available to the public, upon their request, for the next three years. LPA Hogue issued a Notice of Site Visit and verified it was posted in a prominent location at the facility before ending the tele-inspection. Licensee understands that the Notice of Site Visit must remain posted for the next 30 days. No deficiencies were cited during this tele-inspection.

SUPERVISOR'S NAME: Kimberly Williams	TELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Destinee Hogue	TELEPHONE: (951) 218-5196
LICENSING EVALUATOR SIGNATURE:	DATE: 04/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/15/2021

LIC809 (FAS) - (06/04)

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