394500185-2-18-2020-53-CC-GSIH-BLWR4R-20200218114159

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500185
Report Date: 02/18/2020
Date Signed: 02/18/2020 11:42:06 AM

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:	HAMILTON, MONICA		FACILITY NUMBER:	394500185
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	02/18/2020
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Monica Hamilton		TIME COMPLETED:	12:00 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 Analyst (LPA) Gagandeep Singh met with licensee, Monica Hamilton, for a scheduled pre-licensing inspection at the facility. Licensee was operating and licensed (393617334) at previous location. Licensee applied for a change location and change of capacity from large day care to small day care. At new location, licensee lives in a single story house. All the adults living in the house has criminal background clearance on file. Hours of operation are Monday to Friday 6:00 AM to 6:00 PM. Child care will be provided in areas: Living room, Family room, Kitchen, Dining area, Bathroom and Backyard. Off limit areas: All bedrooms, Bathroom next to bedrooms and Garage. All off limits areas are inaccessible to children. Isolation of an ill child will be living room. Applicant was notified that prior to use of any off limits area, the department must be notified. LPA Singh inspected the entire home with the applicant for health and safety hazards. The house has proper temperature and ventilation. All toxic or dangerous materials are stored on high shelf in the cabinets and has child protective locks installed. The house has a working telephone, fully charged fire extinguisher, smoke detector and carbon monoxide detector. There is first aid kit available. Knives in the kitchen are stored at top shelf. There is a variety of age appropriate toys available. As per the applicant, there are no firearms or weapons in the home. Licensee has one pet dog on premises. Licensee is aware of all licensing forms and posting requirements. Per licensee, all of the posting documents will be posted by the main entry door. Licensee has valid CPR training certificate until February 2021. Licensee is aware that fire and emergency drills must be conducted at least once every six months and must be logged. Licensee was informed about the Provider Information Notices (PINs) on CCLD website. See next page for continuation ...................

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020

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: HAMILTON, MONICA	FACILITY NUMBER: 394500185
	VISIT DATE: 02/18/2020

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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

The applicant is encouraged to frequently visit website at http://www.ccld.ca.gov/ for licensing regulations and new updates. Applicant can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

At this time, it is recommended the applicant be granted her license for a small child care home.

Copy of this report was reviewed and provided to licensee. This report will be kept in the facility file and will be made available for public review upon request. Desk Duty is available Monday through Friday between 8 AM - 5 PM at (916) 263-5744.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 02/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020

LIC809 (FAS) - (06/04)

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