393621390-12-8-2021-53-CC-CJAN-C9J2FR-20211208162158

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393621390
Report Date: 12/08/2021
Date Signed: 12/08/2021 04:31:52 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:	STEPHEN, DAISY		FACILITY NUMBER:	393621390
ADMINISTRATOR:	STEPHEN, DAISY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 802-7171
CITY:	MOUNTAIN HOUSE	STATE: CA	ZIP CODE:	95391
CAPACITY:	14	CENSUS:	DATE:	12/08/2021
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Daisy Stephen		TIME COMPLETED:	02:45 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	Licensing Program Analysts (LPAs) Stacey Williams and Christopher Jackson along with Licensing Program Manager (LPM) Bettina Engelman met with licensee, Daisy Stephen for the purpose of an Informal Meeting via zoom due to the ongoing COVID-19 pandemic. LPM Engelman defined the difference between a Non-Compliance and an Informal Meeting. Today's informal meeting was to discuss the findings of a recent complaint, which was filed on September 20, 2021. LPM advised Mrs. Stephen that the purpose of today’s meeting is to help the provider gain compliance. The following citations and regulations were discussed: H&S 1596.885(c) Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state: the licensee was seen interacting with an individual in an inappropriate manner when an argument lead to a heated discussion. 102417(f) (5) To complain to the local licensing office and inspect the family child care home without discrimination or retaliation in accordance with Health and Safety Code Section 1596.857. The Department learned that the licensee had attempted to discuss concerns with individuals involved in filing a complaint against the facility. Report Continues on 809-C

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

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: STEPHEN, DAISY	FACILITY NUMBER: 393621390
	VISIT DATE: 12/08/2021

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Mrs. Stephen said she understands the situation and acknowledged that she will not engage in behaviors that can be deemed conduct inimical. Mrs. Stephen explained that the purpose for contacting the family was to discuss social media postings. Mrs. Stephen stated she is taking the following steps to gain compliance: Moving forward, when dealing with confrontational individuals, the licensee will discuss situations over the telephone, rather than in person. She will update policies regarding schedules and termination for families to sign and acknowledge for the in-home facility. LPM Engelman informed Mrs. Stephen that continued deficiencies may result in further action, including a non-compliance meeting with the Regional Manager.

During the today's meeting LPM Engelman explained resources available to the licensee and provided the link: https://cdss.ca.gov/inforesources/child-care-licensing/resources-for-providers Copies of the links were sent over via email to the licensee, as well as the Departments website www.ccld.ca.gov and for updated regulations and important information regarding licensing.

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 12/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2021

LIC809 (FAS) - (06/04)

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