483009942-10-15-2020-01-CC-GOUE-BUEPUG-20201015113730

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 483009942
Report Date: 10/14/2020
Date Signed: 10/15/2020 11:37:43 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME:	SHARP, KHALISHA & LINCOLN,ROLANDRANEA FCCH		FACILITY NUMBER:	483009942
ADMINISTRATOR:	KHALISHA & ROLANDRANEA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 710-2232
CITY:	SUISUN CITY	STATE: CA	ZIP CODE:	94585
CAPACITY:	14	CENSUS: 0	DATE:	10/14/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Khalisha Sharp		TIME COMPLETED:	03:00 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	The facility inspection was conducted via tele-inspection due to the Covid-19 state of emergency pandemic. The department has suspended all field operations and the applicant has agreed to conduct the video conference with LPA, (Licensing Program Analyst) Glenn Ouye. The purpose of the televisit was to conduct a prelicensing visit. The co-licensee's Khalisha Sharp and Rolandranea Lincoln submitted an application as a large FCCH. LPA Ouye met with co-licensee Khalisha Sharp. The applicant is requesting a license for a capacity of 14 children. Services will be available Monday-Friday, 07:00 AM - 6:00 PM. The applicant understands that 24hr consecutive care is prohibited. The residence is a three bedroom/ three bathroom, dual level home. There are presently three adults living in the home. The applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance. The floor and yard plans are verified. The children will have access to the first floor only. This includes the dining room, living room, kitchen, downstairs bathroom, The entire upstairs if off limits and is made inaccessible with a child safety gate. The home appears to be clean and orderly at this time and will remain so during child care hours. The facility will use a cell phone as the primary telephone in the home. The sharp knives, cleaning supplies, medicines, are stored out of the reach of children. The applicant stated that there are no poisons, firearms or ammunition stored on the premises. The regulation that poisons are to be locked using a key or combination lock was reviewed. First Aid supplies will be maintained at the facility. The children in care will have access to age appropriate toys and equipment. The home is equipped with a working smoke detector and carbon monoxide detector and has a fire extinguisher rated at least 2A10BC. LPA verified that the pull station fire alarm is present in the facility. The home's backyard is fully fenced and used for child care. There is no spa, pool, pond, fountain or other body of water on the premises. None shall be added without prior approval from the Licensing agency.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn Ouye	TELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2020

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, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: SHARP, KHALISHA & LINCOLN,ROLANDRANEA FCCH	FACILITY NUMBER: 483009942
	VISIT DATE: 10/14/2020

NARRATIVE

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Incidental Medical Services (IMS) regulations were reviewed with the applicant. The applicant understands that if Incidental Medical Services are provided, an updated Plan of Operation shall be submitted and on file with the Department.

Parents will be required to sign insurance affidavits if the provider does not plan to purchase additional child care liability insurance. Parent's rights poster is posted. Emergency drills must be conducted at least once every six months and the date documented. The required children's records to be maintained were reviewed. The roster is to remain current at all times. Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report within seven days. The licensee will maintain current pediatric CPR and First Aid certification. The licensee shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. Infants and children shall not be allowed to sleep in car carriers in the home. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged. Smoking is prohibited at all times in any area where child care is provided. The licensee understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website. http://ccld.ca.gov/. Megan's Law web site was provided(http://www.meganslaw.ca.gov). The new infant safe sleep regulations, the AAP Guide to Safe Sleep Practices and the Effects of Lead Exposure brochures were provided and reviewed with the applicant. The applicant understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice.
Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

This facility has been approved for licensure effective October 15, 2020.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn Ouye	TELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2020

LIC809 (FAS) - (06/04)

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