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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393616576
Report Date: 12/19/2019
Date Signed: 12/19/2019 01:43:24 PM

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:HILL, BRANDIFACILITY NUMBER:
393616576
ADMINISTRATOR:HILL, BRANDIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 518-7262
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY:14CENSUS: 7DATE:
12/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Brandi HillTIME COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Singh Licensing Program Manager (LPM) Maria Mayorga met with licensee, Brandi Hill, for an annual random inspection. The purpose of the inspection was explained. Licensee lives in a single family home. Present, there are seven children in care with licensee and one helper. All adults living or working in the home have criminal background check on file. Licensee is operating within the capacity of this date. Licensee provides day care from Monday to Friday between 6 AM to 8 PM.

LPA and LPM inspected the day care areas with the licensee. Entire second floor and garage is off limit. There is no pool, spa or any other body of water in the house. As per licensee, there is no firearm or weapon in the house. Stairs are barricaded with child protective gate. All the cleaning supplies, poisons and other chemicals are stored inaccessible to the children. Fireplace is barricaded. The house is in good repair and free of hazards with proper temperature and ventilation. There is carbon monoxide detector, smoke detector, fully charged fire extinguisher and working telephone available in the house. There is a variety of age appropriate toys in the house.

LPA and LPM review the children's record. LPM reviewed the identification and emergency information form for every child for proper names and numbers filled. Licensee has record of immunization record of each child in care. Licensee has well maintained roster on file. Licensee has record of training of preventive health and CPR card valid until February 2020. Licensee conduct the fire and emergency drills and has a log in place. Per drill log, last drill was conducted in November 2019. Licensee has record of all required staff immunization. Licensee has completed the Mandated Reporter Training and the certificate for general training and child care on file. The training can be obtained online at www.mandatedreporterca.com.

See next page for continuation ..............
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019
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: HILL, BRANDI
FACILITY NUMBER: 393616576
VISIT DATE: 12/19/2019
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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

Licensee is aware of effects of lead exposure and licensee has handout on file. LPA encourage the licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.



No deficiencies are cited today. The copy of this report is reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019
LIC809 (FAS) - (06/04)
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