343622941-1-11-2022-03-CC-JHOA-CAKUL5-20220111144011

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343622941
Report Date: 01/11/2022
Date Signed: 01/11/2022 02:40:20 PM

Document Has Been Signed on 01/11/2022 02:40 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:	MCLORIN-JACKSON,SONYA		FACILITY NUMBER:	343622941
ADMINISTRATOR:	MCLORIN-JACKSON,SONYA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 226-7054
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95828
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	01/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Sonya McLorin-Jackson		TIME COMPLETED:	03:00 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 Tuesday, 01/11/22, Licensing Program Analyst (LPA) Jan Hoshida conducted an unannounced random annual inspection and met with Licensee Sonya McLorin-Jackson. LPA observed there were five day care children present in the facility during this inspection. The off-limit areas include all bedrooms, garage, and side yard. Licensee acknowledged that children may never enter these off-limit areas. Licensee stated there are no new residents in the home since licensure. All adult residents have criminal record clearances. The hours of operation are Monday through Friday from 6:00am to 6:00pm. LPA observed current CPR/First Aid certificates which expire on 2/13/23. LPA observed current Mandated Reporter Training in file and was taken on 07/07/21. LPA reviewed some children’s files. LPA observed fire drills were conducted at least once every six months and documented. LPA observed fireplace which was screened. Fire extinguisher, smoke detector, and carbon monoxide detector meet regulation. Toys appear to be safe. The backyard is fenced and gated. Licensee stated that she does not have weapons in the home. LPA provided Licensee the Safe Sleep PIN 20-24 CCP and Infant Individual Sleeping Plan (LIC 9227). Licensee stated that she does not currently have any children under that age of two years. LPA discussed current COVID guidelines with Licensee. LPA observed that Licensee was wearing a mask. LPA checked facilities fees and confirmed that it is up to date. LPA observed that there were cleaning products that were labeled keep out of reach of children that were accessible to children that were under the kitchen sink and on the counter where the children wash their hands. LPA observed a box cutter that was on the couch in the living room. Licensee immediately removed the box cutter and placed it inaccessible to the children in care. *REPORT CONTINUED ON NEXT PAGE*

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Jan Hoshida
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2022

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: MCLORIN-JACKSON,SONYA	FACILITY NUMBER: 343622941
	VISIT DATE: 01/11/2022

NARRATIVE

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This facility does not currently provide Incidental Medical Services- IMS. 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.

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 Title 22 deficiency is cited on LIC 809-D. Licensee acknowledges, that for TYPE A DEFICIENCIES ONLY upon receipt, Licensee shall post LIC 809-D with Type A deficiency for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the Licensee. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Sonya McLorin-Jackson.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Jan Hoshida
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/11/2022 02:40 PM - It Cannot Be Edited

Created By: Jan Hoshida On 01/11/2022 at 01:59 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: MCLORIN-JACKSON,SONYA	FACILITY NUMBER: 343622941
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102417(g)(4)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. 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 which poses an immediate health, safety or personal rights risk to persons in care. LPA observed that there were cleaning products that were labeled keep out of reach of children that were accessible to children that were under the kitchen sink and on the counter where the children wash their hands. LPA observed a box cutter that was on the couch in the living room. Licensee immediately removed the box cutter and placed it inaccessible to the children in care.
	POC Due Date: 01/12/2022
	Plan of Correction
1 2 3 4	Licensee stated that she will move the cleaning products labeled keep out of reach of children in an off-limits area. LPA will return to clear citation.

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:

Seychelle De Luca

LICENSING EVALUATOR NAME:

Jan Hoshida

LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2022

LIC809 (FAS) - (06/04)

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