343619207-4-20-2022-53-CC-SMAY-CDNU2Q-20220420151218

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343619207
Report Date: 04/20/2022
Date Signed: 04/20/2022 03:12:24 PM

Document Has Been Signed on 04/20/2022 03:12 PM - 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	BAKER, HALLY		FACILITY NUMBER:	343619207
ADMINISTRATOR:	BAKER, HALLY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 681-5008
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	14	CENSUS: 10	DATE:	04/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Hally Baker		TIME COMPLETED:	03:20 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	On April 20, 2022, Licensing Program Analysts (LPAs) Salene Mayberry and Chayntel Hunter met with Licensee Hally Baker, for the purpose of an unannounced annual random inspection. Licensee, assistant Lorina Masoumizadeh and 10 day care children were present during the inspection. Facility hours of operation are Monday – Friday 7:30 am to 5:00 pm. 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. A health and safety inspection was conducted in all areas accessible to children. Off limit areas are the garage, her son’s bedroom, master bedroom, the guitar bedroom, and the right side of the yard (if exiting the home and facing the fence) with the iron fence. Licensee acknowledges that children may never enter these off-limits areas. Upon entry, LPAs observed required postings and a working phone. Fire extinguisher, smoke and carbon monoxide detectors are all functioning and meet requirements. Licensee stated there are no weapons in the home. Toxic and hazardous items are inaccessible to children. Safety latches are in use on some kitchen cabinets and bathroom cabinets and drawers. In the backyard LPAs observed a covered and locked jacuzzi and an empty fountain. LPAs also checked a tool shed and confirmed it was locked. LPAs asked Licensee for the facility records, which include children and staff files. Ten children’s files and three staff files were reviewed. All required forms for the children in care are complete and maintained in the file. LPAs reviewed staff files and confirmed that Licensee's immunization records for measles (MMR), pertussis (Tdap), and the flu are available in the facility file. Report continues on 809-C.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

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: BAKER, HALLY	FACILITY NUMBER: 343619207
	VISIT DATE: 04/20/2022

NARRATIVE

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LPAs confirmed that current in person EMSA CPR and First Aid certification was completed and expires 8/2023 and that AB1207 Mandated Reporter Training was completed expires 12/2023. LPAs observed a current roster, and that fire drills are conducted at least once every six months. LPsA verified the annual fees are current.
Licensee currently does not have any children enrolled that require IMS. If in the future 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

LPAs discussed the safe sleep regulations with Licensee and 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. LPAs 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.

An exit interview conducted, and the report was reviewed with Licensee. Licensee was encouraged to visit the department website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to family child care homes. LPA Mayberry posted a Notice of Site Visit and confirmed Licensee understands it must remain posted for 30 days and that a failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated no deficiencies were cited during todays inspection.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Salene Mayberry	TELEPHONE: 916-263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022

LIC809 (FAS) - (06/04)

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