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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364819798
Report Date: 04/26/2023
Date Signed: 04/26/2023 04:48:14 PM


Document Has Been Signed on 04/26/2023 04:48 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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:INGRAM FAMILY CHILD CAREFACILITY NUMBER:
364819798
ADMINISTRATOR:INGRAM, NICOLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 422-9938
CITY:GRAND TERRACESTATE: CAZIP CODE:
92313
CAPACITY:14CENSUS: 0DATE:
04/26/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
01:27 PM
MET WITH:Licensee Nicole IngramTIME COMPLETED:
04:50 PM
NARRATIVE
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On 04/26/2022, an Informal Conference was held at the Riverside Regional Office. Present in the conference were Licensee Nicole Ingram; Licensing Program Manager (LPM) Gilbert Sena and Licensing Program Analysts (LPAs) Susan Brewer and Perla Ordones.

The conference was held to discuss the following sections of Title 22 Regulations and Health and Safety Code:
· Non-compliance history was reviewed during the conference.
· Outstanding Plan of Corrections
· 102417 Operation of a Family Child Care Home
· 102370 Criminal Record Clearance / Criminal Record Exemptions
· 102416.5 Staffing Ratio and Capacity
· 102425 Infant Safe Sleep regulations
· 102421 Children records
· 102416.1 Personnel records
· 102418 Child Immunization Records/SB227 and Adult Immunization Records/SB792 - California Health and Safety Code Section 1597.622 (a)(1)
· Mandated Reporter Training-Health and Safety Code Section 1596.8662

Licensee agrees to submit the following by 04/28/2023: Remaining Plan of Corrections issued on 03/30/2023 for Personnel records, Immunization records and Mandated Reporter Training Certificates for Staff; Children's records to include LIC700 Emergency Identifications, LIC9224 Acknowledgements for 03/30/2023, 04/04/2023, 04/26/2023 Inspections, Office visits and pending children's immunization records. The department is requesting the following licensee documents: Updated Proof of Influenza or letter to decline, Mandated Reporter Training Certificates and Control of Property.

SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2023
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
INLAND EMPIRE CHILD, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: INGRAM FAMILY CHILD CARE
FACILITY NUMBER: 364819798
VISIT DATE: 04/26/2023
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During today's conference, the following documents were discussed and provided to Licensee: Title 22 Regulations and Health & Safety code identified above:
  • PIN 23-07-CCLD GUARDIAN TRAINING WEBINAR FOR LICENSEES AND PROVIDERS
  • PIN 23-07-CCP PROVIDER WEBINAR: ASK THE CHILD CARE ADVOCATES,
  • PIN 19-17-CCP CDSS ONLINE CHILD ABUSE MANDATED REPORTER TRAINING CHANGES;
  • PIN 22-30-CCP CHILD CARE LICENSING WEBINARS
  • PIN 23-09-CCLD PROVIDER WEBINAR: INTO TO THE TECHNICAL SUPPORT PROGRAM;

Technical Support Program (TSP) was discussed and information related to TSP was provided to Licensee. Licensee has an option to enroll in TSP. If Licensee agrees to enroll in TSP, she agrees to notify the Department within 30 days of this report.

Licensee was advised to visit the Department's website at: https://cdss.ca.gov/inforesources/child-care-licensing/resources-for-providers on a regular basis for licensing updates. Licensee was advised to review Family Child Care Provider videos related to: Child Care Reporting Requirements; Supervising Children in Family Child Care; Record Keeping in Family Child Care and Infant Safe Sleep Standards. Child Care Provider video website link was provided to the Licensee during this conference.

During this conference, contact information of the local Resource and Referral Agency, Child Care Resource Center (CCRC) at (909) 890-0018, was provided to Licensee. Licensee agrees to ensure that the facility is operating in substantial compliance of California Code of Regulations Title 22, Division 12.

An exit interview was conducted Licensee, Nicole Ingram.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 782-4200
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 782-4200
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2023
LIC809 (FAS) - (06/04)
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