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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343619123
Report Date: 03/08/2024
Date Signed: 03/11/2024 09:10:36 AM


Document Has Been Signed on 03/11/2024 09:10 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827



FACILITY NAME:ABDULLAH, CHARMAINEFACILITY NUMBER:
343619123
ADMINISTRATOR:ABDULLAH, CHARMAINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 739-1599
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY:14CENSUS: 8DATE:
03/08/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Charmaine AbdullahTIME COMPLETED:
12:15 PM
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On Friday, March 8, 2024 at 10:35 AM, Licensing Program Analyst (LPA) Tanya Washington arrived to the facility for the purpose of an unannounced annual inspection. Upon arrival, at 10:35 AM LPA observed Staff #1 providing care and supervision to two infants and six preschool aged children. There were no other adults present in the home. Staff #1 was out of ratio during the inspection. Licensee Abdul arrived to the facility approximately at 10:50 AM. All individuals subject to criminal background review have obtained a criminal record clearance. Licensee confirmed that there are no new residents or employees since the last inspection. Facility hours of operation are Monday- Thursday from 8 AM to 5 PM and on Friday's from 8 AM to 4 PM.

A health and safety evaluation was conducted in all areas accessible to children. Off-limit areas include: family room, bedroom #2, #3, laundry room and backyard. Licensee acknowledged that children may never enter these off-limit areas. LPA observed that the facility is clean, safe, sanitary, and in good repair. LPA observed a functioning smoke detector, carbon monoxide detector, and a full 2A10BC fire extinguisher. The facility has adequate toys that appear to be safe for children to use. The licensee stated there are no weapons or poisons in the home. The fireplace in the living room (playroom) is not in use and properly barricaded. There are no bodies of water on the premises.

LPA reviewed five children’s files which were observed to be complete. Required postings and the children’s roster were observed. LPA observed a current fire drill log, last drill was documented 02/09/2024. LPA observed Staff #1 and Licensee with current CPR and First Aid certification, LPA also observed current Mandated Reporter training for both the Licensee and Staff #1.

LPA verified that the annual fees are current. Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

PAGE 1. REPORT CONTINUES ON LIC809-C
SUPERVISOR'S NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ABDULLAH, CHARMAINE
FACILITY NUMBER: 343619123
VISIT DATE: 03/08/2024
NARRATIVE
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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.

Licensee understands that licenses are not transferable, and once licensed, licensee must live in the home and be present for 80% of the operating hours. Licensee understands that if an unusual incident occurs; licensing is to be notified via phone call, e-mail or fax within 24 hours and the Unusual Incident Report/LIC 624 shall be submitted within 7 days to remain in compliance. Licensee understands that if any structural changes are made to the home; licensing must be notified PRIOR to construction. Licensee understands that if she wants to make any changes to OFF-limit areas to an ON-limit area, she must notify licensing and LPA must do an inspection BEFORE children are allowed in said area. Licensee understands that children’s records are to be maintained according to Title 22 regulations and be accessible to licensing for up to 3 years.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Page 2. REPORT CONTINUES ON LIC809C
SUPERVISOR'S NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: ABDULLAH, CHARMAINE
FACILITY NUMBER: 343619123
VISIT DATE: 03/08/2024
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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Upon receipt, licensee shall post and provide copies of this licensing report to parents/ guardians of children who are currently enrolled as well as parents/ guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must acknowledge receipt of this report and citation by signing a LIC9224, “ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS”. A copy of this form should be placed in each child file upon receipt from parent.

An exit interview was conducted. The notice of site visit was posted and should remain posted for 30 days for parental review. Appeal rights were discussed and provided to Licensee Abdullah.

SUPERVISOR'S NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 03/11/2024 09:10 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827


FACILITY NAME: ABDULLAH, CHARMAINE
FACILITY NUMBER: 343619123

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/08/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care. LPA observed six preschoolers and two infants in care of Staff #1.
POC Due Date: 03/11/2024
Plan of Correction
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The Licensee stated she will submit a written plan of corretion to LPA by POC date of 3/11/2024. Licensee also stated that she will be bringing.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR NAME: Tanya WashingtonTELEPHONE: 916-879-1209
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2024
LIC809 (FAS) - (06/04)
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