<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500389
Report Date: 04/06/2021
Date Signed: 04/07/2021 10:48:16 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:BROWN, TILESHAFACILITY NUMBER:
394500389
ADMINISTRATOR:TILESHA BROWNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 513-1241
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:14CENSUS: 0DATE:
04/06/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Tilesha BrownTIME COMPLETED:
09:00 AM
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
*NOTE: Due to Covid-19 State of Emergency and DPH guidelines on social distancing, a facetime meeting was conducted.*
On 6th April 2021 at 8:00am Licensing Program Analyst (LPA) Aruna Sridharan conducted tele-inspection via Facetime with licensee Tilesha Brown for an announced change of location per licensee's request. Licensee moved from previous licensed(393621010) address: 9717 Milan Drive, Stockton CA 95212 to current home at 5839 Caribbean Circle, Stockton, CA 95210. The hours of operation are Monday-Saturday for 24 hours. The fire clearance was received on 03/18/2021. All adults are fingerprint cleared.
LPA toured the home inside and out. The licensee owns the home which is a two storey home with four bedrooms and three bathrooms. OFF LIMIT areas include: entire upstairs, garage, shed and the fenced backyard corner around the shed. Licensee acknowledges that children may never enter these off-limit areas.
The entire outside area was toured and no bodies of water were found. The front yard is unfenced and the backyard area is fenced and has a shed which is under lock and key. The licensee understands that 100% supervision is needed when children are in an unfenced area. Licensee understands that prior to making altercations or additions to the home or grounds the licensee shall notify Licensing Agency per regulation 102416.3
Home has working carbon monoxide and smoke detectors that meet regulations. The 2A-10-B-C fire extinguisher and first aid kit are wall mounted in the kitchen. The stairs are barricaded, fireplace is screened. There are no firearms as stated by licensee. Hazardous cleaning compounds are stored in the locked cabinet under the sink. Sharp utensils like knives are stored in the corner upper cabinet above the microwave in the kitchen inaccessible to children. The medications are stored in upper cabinet in the kitchen out of reach of children. The home contains appropriate toys for the children.
The Licensee has certificates of completion for 15 hours of health and safety training including Lead Poisoning Prevention module certificate. Licensee has CPR and First Aid (exp:07/2021) and Mandated Reporter (exp: 03/2022).
Licensee is following COVID guidelines and precautions to provide care for children at this time.
LPA has provided the licensee with the web site www.ccld.ca.gov to enable access to all updated forms, requirements and changes. LPA advised the licensee of their responsibility to stay current in the requirements of the Department. LPA reviewed the fire drill requirements. LPA reviewed postings. Licensee currently does not have liability insurance and will be using the affidavit for parents to sign.
LPA will recommend approval for a change of location as of today.
Notice of Site Visit was posted.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Aruna SridharanTELEPHONE: (916) 917-9273
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1