376628993-1-28-2021-20-CC-MHEZ-BXQ3D2-20210128170848

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628993
Report Date: 01/28/2021
Date Signed: 01/28/2021 05:10:23 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	NICHOLS, SHEREE FAMILY CHILD CARE		FACILITY NUMBER:	376628993
ADMINISTRATOR:	SHEREE NICHOLS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 318-3613
CITY:	LA MESA	STATE: CA	ZIP CODE:	91941
CAPACITY:	14	CENSUS: 0	DATE:	01/28/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:07 PM
MET WITH:	Sheree Nichols, Applicant		TIME COMPLETED:	04:07 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 January 28, 2021 at 2:07 PM, Licensing Program Analyst (LPA), Marie Hernandez conducted an announced Tele-Conference Pre-licensing and RAST Inspection due to the COVID -19 State of Emergency via Facetime with the Applicant, Sheree Nichols. The purpose of the inspection is to ensure the home is incompliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This is a two story five bedroom and four bath home. The hours of operation are Monday through Friday, from 7:00 AM to 5:30 PM. The fire department approved the fire clearance on 01/19/2021. LPA toured and inspected the home. The Applicant will use the following areas for childcare: Downstairs, the family room, bedroom #1 with the attached bathroom (napping room) and bedroom #2 (play room). The off-limit area is the entire upstairs (2nd floor) including the upstairs bedrooms, bathrooms, kitchen and living room. The off limit areas are inaccessible to children through the use of a child proof safety gate. The downstairs laundry room and the bathroom near the laundry room are off limits via a child proof safety gate. The entire backyard is off limits via a locked door. The front yard will be used for outdoor activities of children. The Garage is off limits via a locked door. The fire extinguisher meets the requirement. The required smoke detector and carbon monoxide detector are operational. All poisons, detergents, cleaning compounds and medicines are secured, inaccessible and out of reach of children. Age appropriate toys and play equipment are available. A working telephone is available. The Applicant indicated there are no firearms or weapons in the home. There are no bodies of water in the home. The Applicant maintains documentation of proof of control of property for review by the Department. Discussed the Mandated Reporter AB1207 online training. The AB1207 must be renewed every two years. The Applicant has completed the eight hours of preventative health certification. The pediatric CPR and First Aid certification expires 07/13/2021. The required documents are posted. The Applicant and the adult residents have the criminal record clearances on file. The Applicant was advised that any new/additional adults must be cleared prior to working or residing in the home. Any minor upon their 18th birthday must be fingerprinted within 30 days. Immunization records per SB792 were reviewed and are incompliance. LPA advised that prior to making alterations or additions to the home or grounds, the Applicant shall notify the Department of the proposed changes. The Applicant states she is financially secure to operate a family childcare home for children and will comply with all regulations and laws governing family childcare homes.

SUPERVISOR'S NAME: Joe Carrasco	TELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Marie Hernandez	TELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2021

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 2

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: NICHOLS, SHEREE FAMILY CHILD CARE	FACILITY NUMBER: 376628993
	VISIT DATE: 01/28/2021

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
26
27
28
29
30
31
32

The Applicant does not plan on providing Incidental Medical Services (IMS) to children at this time. 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. Megan’s Law was discussed meganslaw.ca.gov.

A New Provider Resource Packet was reviewed with the Applicant including information on the following: Safe Sleep, SIDS, shaken baby, child abuse reporting, community resources, YMCA Childcare Resource Service, children’s records, facility records, required postings, immunization's, unusual incident report, facility roster, car seat law, visual for ratio/capacity, fire/disaster drill log and prohibited items including no smoking or corporal punishment in a day care. LPA discussed the maximum capacity for a large family child care home: Maximum capacity (WHEN THERE IS AN ASSISTANT PRESENT): 12 - No more than 4 infants (infant means any child under 24 months). Capacity of 14 - No more than 3 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the home. When there is no assistant available, the Licensee must revert back to a small family child care home. Discussed and provided the Covid-19 postings. LPA discussed the Guardian for background checks and disassociation's with the Applicant.

The Applicant is advised to regularly visit the Community Care Licensing WEBSITE:www.cdss.ca.gov for quarterly updates and updated regulation information. The Duty Line was provided: (619) 767-2248. Southern California Child Care Advocate information was provided, and the Applicant was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information. The Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

The Applicant is ready for licensure effective today (01/28/2021). A license will be issued and emailed to the Applicant. LPA Marie Hernandez explained the inspection report, and the Applicant stated she understood. An exit interview was conducted, and a copy of the report was emailed to the Applicant. The Applicant was advised that acknowledgement of the receipt of the report is to be received within 24 hours. NOTE on Facility Signature: SEE FILE FOR ACKNOWLEDGEMENT.

SUPERVISOR'S NAME: Joe Carrasco	TELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Marie Hernandez	TELEPHONE: (619) 767-2244
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2