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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393605369
Report Date: 07/08/2022
Date Signed: 07/08/2022 04:03:51 PM


Document Has Been Signed on 07/08/2022 04:03 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:IVY, ROBINFACILITY NUMBER:
393605369
ADMINISTRATOR:IVY, ROBINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 986-2678
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY:14CENSUS: 2DATE:
07/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Joselyn Ivy and Laure EasterTIME COMPLETED:
04:15 PM
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On Friday, July 08. 2022, at 02:00pm, Licensing Program Analyst (LPA) Elvira Sierra visit the facility for the purpose of an unannounced Annual inspection. Present in the facility were Licensee's daughters, Lauren Easter and Joselyn Ivy caring for two daycare children. Also present in the facility were three Licensee's grandchildren (16 y/o, 2 y/o and six months). Facility hours of operation are M-F 24 hours a day. LPA advised to not exceed 24 hours of consecutive care. A review of the Facility Personnel Summary shows that all adults living and working in the home have criminal record clearances on file with Licensing Office. Capacity specified on the license was met on today’s inspection.

A health and safety inspection was conducted in all areas accessible to children. Off limit areas are: Upstairs level and garage. Upon entry, LPA observed the posting of the facility license, Emergency Disaster Plan, Earthquake Preparedness Checklist and Notification of Parent Rights. Home is appropriately ventilated. Facility maintains a working phone, 2A10BC fire extinguisher, and functioning smoke/carbon monoxide detector. Age appropriate toys and reading material were observed. Licensee's Assistants stated there are no weapons in the home and no bodies of water were observed. Toxic and hazardous items are inaccessible to children.The fireplace in the home is appropriately barricaded to prevent access by children and outdoor play space is fenced for supervision.

At 03:10pm, LPA reviewed two children files. Current in person EMSA CPR and First Aid certification was verified for an Assistant and expires 08/26/2023. LPA observed a current roster and LPA advised that fire drills must be documented and conducted at least once every six months.

Report continues on 809-C.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:
DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2022
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: IVY, ROBIN
FACILITY NUMBER: 393605369
VISIT DATE: 07/08/2022
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LPA verified the annual fees are current. Licensee's assistant 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.

Incidental Medical Services (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



LPA discussed the safe sleep regulations with Licensee's assistant 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 staff 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.


A notice of site visit was given and must remain posted for 30 days. LPA posted the Notice of Site Visit on today’s inspection. Exit interview conducted and report was reviewed with the Licensee's assistant, Joselyn Ivy.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
LIC809 (FAS) - (06/04)
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