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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013416289
Report Date: 03/05/2020
Date Signed: 09/27/2024 07:57:39 AM

Document Has Been Signed on 09/27/2024 07:57 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:SIMS-HARPER, CARMENFACILITY NUMBER:
013416289
ADMINISTRATOR:SIMS-HARPER, CARMENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 530-4745
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
03/05/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Shalyla Alston/Carmen Sims-HarperTIME COMPLETED:
05:40 PM
NARRATIVE
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On 03/05/2020 at 02:45 PM Licensing Program Analysts (LPAs) Arminder Singh and Monica Mathur conducted an unannounced Annual/Random Inspection at Carmen Sims-Harper's Family Day Care Home. LPAs met with Assistants, Shayla Alston and Fanny Hernandez and explained the purpose of today’s inspection. Present in the home were two fingerprint cleared assistants, and 12 children (5 infants, 7 preschoolers). Facility was not in compliance with Staffing Ratios & Capacity regulation. Shayla stated that Licensee was out running errands. Children were engaged in various activities under the supervision of the Assistants. Days and hours of operation are Monday - Friday from 7:00 AM - 6:00 PM.
At 03:00 PM LPAs toured the indoor and outdoor areas of the home during today's inspection. The home is a two story home. The home consists of a living room, dining room, kitchen, six bedrooms, and two bathrooms, unfenced front yard and fenced backyard. The bedrooms located upstairs, one bathroom located upstairs and unfenced front yard are the off limit areas.
INDOOR SPACE: In Use Areas: The lower level of home is on limits which includes dining room, living room, front room, kitchen, bathroom #1, bedroom #1, and the backyard
Off Limit Areas: The entire upstairs area, front room of the house, front yard are the off limit areas.
The Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children in the home. Furniture and equipment, such as mats and tables were age appropriate and in good condition. There were no baby walkers or bouncers observed on the premise during today’s inspection. LPA's did not observe any wall heaters in the home.
CONTINUED ON NEXT PAGE
SUPERVISORS NAME: Ann Robinson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE: DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/05/2020
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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Document Has Been Signed on 09/27/2024 07:57 AM - It Cannot Be Edited


Created By: Arminder Singh On 03/05/2020 at 03:47 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: SIMS-HARPER, CARMEN
FACILITY NUMBER: 013416289

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/06/2020
Section Cited
CCR
102416.5(d)(1)

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102416.5 Staffing Ratio and Capacity (d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either:(1) Twelve children, no more than four of whom may be infants; or
This requirement is not met as evidenced by:
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By POC Date Licensse agree to send written statement of:
1. Understanding of the regulation
2. Schedule of all children that ensures facility is in compliance with ratios at all times.
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Per LPA's observation there were 5 infants and 7 preschoolers at the time of inspection. Facility was out of ratio by 1 extra infant. This poses an immediate risk to the health and safety of children in care.
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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:Ann Robinson
LICENSING EVALUATOR NAME:Arminder Singh
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2020


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Document Has Been Signed on 09/27/2024 07:57 AM - It Cannot Be Edited


Created By: Arminder Singh On 03/05/2020 at 04:02 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: SIMS-HARPER, CARMEN
FACILITY NUMBER: 013416289

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/05/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/16/2020
Section Cited
HSC
1596.8662(b)(1)

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1596.8662 (b) (1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training [...] This requirement was not met as evidenced by:
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By POC date, Licensee agrees to complete mandated reporter training for herself and all assistants. Licensee will send a reciept of completion of training to CCLD.
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Per LPA's review of files Licensee and staff 1 and 2 (S1, S2) do not have Mandated Reporter Training. This poses potential risk to the healthand safety of children in care.
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Type B
03/09/2020
Section Cited
CCR102417(g)(8)

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102417 Operation of a Family Child (g)(8):Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.This requirement is not met as evidenced by:
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By POC Due Date 03/09/2020 Licensee agreed to submit a current roster of children in care as a proof of correction.
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Per LPAs review of documents, Licensee failed to provide current roster of children in care. This poses a potential risk to the health & safety of children in care.
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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:Ann Robinson
LICENSING EVALUATOR NAME:Arminder Singh
LICENSING EVALUATOR SIGNATURE:
DATE: 03/05/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/05/2020


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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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SIMS-HARPER, CARMEN
FACILITY NUMBER: 013416289
VISIT DATE: 03/05/2020
NARRATIVE
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LPA reminded Licensee of the applicable civil penalties for those adults who have not received fingerprint clearances, are not associated to the license and who comes in contact with or provide care and supervision to the children. Penalty amounts: $100.00 per person per day, minimum of $100.00 to a maximum of $500.00 per person for an initial violation and a minimum of $100.00 to a maximum of $3000.00 per person for any subsequent violation within a 12-month period.

Licensee and both Assistants (S1 and S2) do not have required Mandated Reporter Training per AB1207. LPA advised the Licensee of the required Mandated Reporter Training for Child Care Providers that all Licensees and employees are required to complete as of January 1, 2018. The website for the online training is: http://www.mandatedreporterca.com/training/childcare.htm.

Individual Medical Services (IMS) policy was discussed. The Licensee stated that she currently does not have any one child in care who requires IMS. 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

Beginning January 1, 2019 AB 2370 requires licensed homes and centers to share information on the risks and effects of lead exposure with enrolling and re-enrolling families. LPA provided a copy of the “Lead Poisoning Facts Information Flyer” and “Safe Sleep Information Flyer” to Licensee.


SUPERVISORS NAME: Ann Robinson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
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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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SIMS-HARPER, CARMEN
FACILITY NUMBER: 013416289
VISIT DATE: 03/05/2020
NARRATIVE
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OUTDOOR SPACE: In Use Areas: The backyard is on limits. The outdoor space and play equipment were observed to be maintained in safe condition and free of hazards. The yard was fenced and there were no bodies of water. The side of the yards are properly barricaded and gated and made inaccessible to children.

LPA's observed a fully charged 3A40BC fire extinguisher in the kitchen. Facility has working smoke / carbon monoxide detectors. The Licensee states that there are no weapons in the home. Licensee does have two pet rabbits in the home. . All required postings including but not limited to Parent Rights Poster, Facility License, Emergency Disaster Plan were observed posted on a wall in the Kitchen area. The Licensee states that she does not transport children. Licensee states that the parent's provide formula powder and Licensee provides food and snacks. Food storage area was observed to be sanitary and safe.

At 3;15 PM one (1) infant left the facility making the ratio: 4 infants, 7 preschoolers (total 11).

FILE REVIEW:
At 03:40 PM five (5) Children's files were reviewed and contained all required Licensing forms and records including but not limited to Receipt for Parents' Rights, Identification & Emergency Information, Health History. Two (2) staff file was reviewed and contained all required Licensing forms. LPA's reminded licensee that mandatary reporter training is supposed to be conducted and is valid for two years when completed.. Pediatric CPR/First Aid Certificates were current for staff members and Licensee.

Supervision of children was discussed with the Licensee and she understands that she must be present in the home during 80% of the operating hours of the day care and ensure that the children are supervised at all times. The Licensee understands the capacity options and that she cannot have more than 8 children in the home at any time without at least two qualified adults present. Licensee also understands that she must comply with the ratio and capacity requirements of the Small Family Child Care Home license whenever she or a qualified adult is alone with the children.
CONTINUED ON NEXT PAGE
SUPERVISORS NAME: Ann Robinson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: SIMS-HARPER, CARMEN
FACILITY NUMBER: 013416289
VISIT DATE: 03/05/2020
NARRATIVE
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Sign up for Quarterly Newsletter:
ccld.ca.gov or email: childcareadvocatesprogram@dss.ca.gov

Deficiencies were cited during today’s inspection. See LIC 809-D Pages

Licensee did not have current Child Roster during inspection.

Licensee was reminded that fire/disaster drills are to be conducted and logged every six months.

Deficiencies were cited during today's inspection See 809;D pages.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall POST and PROVIDE copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgment form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.


At 4:30PM an exit interview was conducted with the licensee. The licensee was provided a copy of her/his appeal rights and the signature on this form acknowledges receipt of these rights. A Notice of Site visit was posted at the time of inspection and must remain posted for 30 days.

SUPERVISORS NAME: Ann Robinson
LICENSING EVALUATOR NAME: Arminder Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 03/05/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020
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