493010038-6-3-2021-01-CC-ASTR-C3MSDM-20210603134723

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 493010038
Report Date: 06/03/2021
Date Signed: 06/03/2021 01:48:13 PM

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:	EL, SHELDON FCCH		FACILITY NUMBER:	493010038
ADMINISTRATOR:	EL, SHELDON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 708-8676
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95404
CAPACITY:	14	CENSUS: 7	DATE:	06/03/2021
TYPE OF VISIT:	Case Management - Deficiencies	UNANNOUNCED	TIME BEGAN:	08:57 AM
MET WITH:	Lindsay Fincher and Sheldon El		TIME COMPLETED:	11:20 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	While Licensing Program Analyst (LPA) Amy Strother was conducting a remote FaceTime Tele-Inspection visit with assistant Lindsay Fincher, Staff 1 (S1) in relation to another matter, S1 stated at 8:57am that Licensee Sheldon El (L1) was not currently home and that she was working alone with 4 children. At 9:00am LPA Strother requested a tour of the facility using Facetime. S1 stated that the camera on her phone was cracked and doesn't really work. LPA asked S1 to give the camera a try. S1 agreed to switch over to FaceTime and give a remote video tour of the facility. The view using FaceTime was clear. During the tour, LPA observed one child, Child 1 (C1) in S1's arms. S1 started the virtual tour by touring the hallway, living room, kitchen, backyard and two bathrooms; LPA did not observe any children present in these areas of the home. Next, S1 moved to the front door of the facility. To the right of the front door a nap room was toured. LPA observed 4 wooden cribs and one nap bed on the floor of the nap room, and no children present. LPA requested to go into the room across from the nap room. LPA observed that the door across from the nap room was closed. At 9:05am S1 stated that the room across from the nap room is the playroom and that an assistant, Staff 2 (S2) had just arrived and was in the playroom with the other children and her own child, Child 7 (C7). At 9:06am S1 opened the door to the playroom. LPA observed more than the previously stated, 4 children in care. LPA requested that S1 state each child's name while doing a head count. In the playroom, LPA observed a total of 7 children, Child 1 - Child 7 (C1-C7) in care with S1 and S2. Child 1 - Child 7 all appeared to be infants, under the age of 2. The maximum number of infants in care can be no more than 4. LPA requested that S1 look at the roster of children in care and provide the dates of birth (DOB) for C1-C7. LPA noted the DOB for Child 1 - Child 7 as S1 read them off, noting C1-C7 were all under the age of 2. LPA informed S1 that the facility was operating over ratio by 3 infants and that 3 children will need to be picked up immediately. At 9:28am LPA switched over to FaceTime on S2's phone at the request of S1. S1 stated that she had parents contact information in her phone and would need to use it to call a parent. At 9:40am S1 called the mother of C2 and C3 requesting that she come and pick up her children. At 10:02am L1 arrived to the facility. Continue on LIC809-C

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

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

FACILITY NAME: EL, SHELDON FCCH	FACILITY NUMBER: 493010038
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/03/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 06/04/2021 Section Cited	1 2 3 4 5 6 7	Staffing Ratio and Capacity: For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time... shall be either:(1) Twelve children, no more than four of whom may be infants; or... This requirement is not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation and interview the licensee did not limit ratio and capacity to only 4 infants at any one time, 7 infants (C1-C7) were observed in care during a tour of the facility, which poses an immediate Health and Safety risk to the children in care.	8 9 10 11 12 13 14	on the Capacity Requirements for Large Family Child Care Homes handout (provided by LPA via email) stating that she has read and understands the ratio and capacity requirements in an email to LPA by 06/04/21.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

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: EL, SHELDON FCCH	FACILITY NUMBER: 493010038
	VISIT DATE: 06/03/2021

NARRATIVE

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Continued from LIC809

L1 stated that she was at the home this morning when care began at 6:00am and left the home at 8:00am, returning at 10:00am. At 10:41am L1 stated that S2 went home, taking her child C7 with her. At 11:08am L1 stated that C2 and C3 were picked up from the facility . At 11:11am LPA toured the facility with L1 to confirm that C2, C3 and C7 were no longer at the facility. LPA observed 4 infants, C1, C4, C5, and C6 in care with S1 and L1, meeting ratio and capacity requirements.

The following violation of the California Code of Regulations, Title 22; Division 12, were cited: see LIC 809-D. Appeal Rights were provided.

Reports citing Type A violations are to be provided to parents/guardians of children currently enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC 9224 to be kept in each child's file.

L1’s signature was not recorded on this Facility Evaluation Report (LIC809); however, L1 was provided with a copy of the LIC 809 by email; and L1’s confirmation of read receipt is on file.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

LIC809 (FAS) - (06/04)

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