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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422956
Report Date: 03/09/2022
Date Signed: 03/11/2022 11:14:45 AM

Document Has Been Signed on 03/11/2022 11:14 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:CARTER, CHRISTINAFACILITY NUMBER:
013422956
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
03/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Licensee, Carter ChristinaTIME COMPLETED:
03:20 PM
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******** THIS IS AN AMENDED REPORT FROM ORIGINAL DATED 3/9/2022 *********

Licensing Program Analyst (LPA), Jyoti Saini met with Licensee, Carter Christina for an annual Random inspection. Purpose of the inspection was explained. Present during this inspection was Licensee and helper supervising 3 infants. Capacity and ratio requirements of children was observed in compliance today. Licensee lives in the house with her husband and two minors. The home is two story consisting of the living/dining room area, kitchen, family room, three bedrooms, and two bathrooms upstairs and the Nap Room, Daycare Room and one bathroom downstairs. The off-limits areas for children is made inaccessible by child safety gating at the base of the stairs. The garage and all back-wood decks are also off limits. Chemical, detergents, cleaning compounds, medications, and other items of this nature are made inaccessible to children. First aid supplies are available for children. Home has a fully charged fire extinguisher, and functioning smoke and carbon monoxide detectors. Provider states there are no guns or weapons in the home. LPA did not observe any body of water in the day care area. The home is clean and orderly with sufficient lighting and ventilation. The fireplace in the day care area is properly barricaded. Last fire drill was conducted on 01/04/2022 and properly logged. Providers CPR expires in 04/2023. Home has age appropriate toys and equipment available for the children in care. All the Postings are posted in the main playroom of the Daycare area. Provider is reminded of NO walker, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible. A copy of the children’s roster was available for review and copy was obtained.

During Inspection, Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

see next page...

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE: DATE: 03/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/09/2022
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 03/11/2022 11:16 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 03/10/2022 03:24 PM


Created By: Jyoti Saini On 03/09/2022 at 02:11 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
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: CARTER, CHRISTINA
FACILITY NUMBER: 013422956

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Section Cited
Criminal Record Clearance
Deficient Practice Statement
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The deficiency previously cited on 03/09/2022 has been dismissed.
POC Due Date:
Plan of Correction
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Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Wynn Norona
LICENSING EVALUATOR NAME:Jyoti Saini
LICENSING EVALUATOR SIGNATURE:
DATE: 03/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/09/2022


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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: CARTER, CHRISTINA
FACILITY NUMBER: 013422956
VISIT DATE: 03/09/2022
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
Licensee was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com
For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

Upon further review, it has been found that there was a discrepancy in the system regarding S1's fingerprint clearance and association to the facility; therefore, no citation was given on 03/09/2022.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Carter Christina

SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022
LIC809 (FAS) - (06/04)
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