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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393620862
Report Date: 02/25/2022
Date Signed: 02/25/2022 12:51:00 PM


Document Has Been Signed on 02/25/2022 12:51 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:MILLER-LITTLE, DELINAFACILITY NUMBER:
393620862
ADMINISTRATOR:MILLER-LITTLE, DELINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 952-8862
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:14CENSUS: 4DATE:
02/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Delina Miller-LittleTIME COMPLETED:
01:15 PM
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At 11:30am Licensing Program Analyst (LPA) Aruna Sridharan met with licensee's assistant Samantha Chanty and stated that purpose of today's visit was for annual inspection. The licensee came to the facility in 15 minutes. The facility operates Monday through Friday from 6:30am to 6:30pm. LPA toured all areas of the home that are accessible to the children. Today’s census was 4 preschool children. LPA observed that all adult residents residing have criminal record clearances. LPA observed posting of the license, Parent's Rights and the current disaster plan.

Off-limit areas include entire upstairs and garage. Licensee acknowledged that children may never enter these off-limit areas. The backyard is fenced and licensee acknowledges that children may never be left unsupervised in an unfenced area of the yard. Licensee has weapons which are stored according to regulations. There are no fireplace and no bodies of water. The fire extinguisher, smoke detector and carbon monoxide detector meets regulation. LPA observed that poisons, cleaning materials, hazardous items and medications are all inaccessible to children. There is a working telephone, toys appear to be in a safe condition and the home appears to be clean and orderly.

LPA observed current CPR and First Aid certificate that expires on 12/2022 and mandated reporter certificate expires on 10/2022. LPA observed Fire Drill Log and the last fire drill was conducted on 9/21. LPA observed all children's files and the required forms were duly signed by the authorized representative. LPA provided the Community Care Licensing’s website www.ccld.ca.gov, so the licensee can obtain updated licensing information, new regulations and access forms.

LPA discussed the new Immunization Regulations SB 792, the requirement that all individuals working or volunteering at a licensed Child Care facility must have immunization against measles, pertussis and influenza. LPA conducted file reviews and observed proof of immunizations.
Report continues on 809C....
SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022
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: MILLER-LITTLE, DELINA
FACILITY NUMBER: 393620862
VISIT DATE: 02/25/2022
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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

LPA also discussed Unusual Incident Reports (UIRs) and reporting requirements. LPA informed the licensee that if any unusual incidents occur she must contact the Department within 24 hours and an UIR must be submitted with 7 days, describing the specifics to the incident.

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/inspection-process.

Licensee Delina Miller-Little 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 [or facility representative] 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 [facility representative] 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.

No Title 22 Deficiencies observed in the areas that were evaluated during today's inspection. LPA read this report to the licensee; she stated that understands today’s inspection. Exit interview conducted and report was reviewed with the licensee Anzias Evans. A notice of site visit was given and must remain posted for 30 days.

SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/28/2022 05:26 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 02/28/2022 05:19 PM

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: MILLER-LITTLE, DELINA

FACILITY NUMBER: 393620862

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 02/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
General Provisions and Definitions
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Justin L DentonTELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2022
LIC809 (FAS) - (06/04)
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