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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422956
Report Date: 01/24/2023
Date Signed: 01/24/2023 12:09:19 PM

Document Has Been Signed on 01/24/2023 12:09 PM - 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: 2DATE:
01/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Christina CarterTIME COMPLETED:
01:19 PM
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Licensing Program Analyst Sidney Cortez, arrived and met with licensee Christina Carter for an UNANNOUNCED ANNUAL RANDOM INSPECTION. Present for this visit was the licensee, her fingerprinted employee Destiny Garcia, and 2 infants, and the licensee’s 10 month old son. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 7:30AM until 4:30 PM, MONDAY-FRIDAY.The home is two stories 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. On Limit area (1st floor): downstairs: inside: play room area, nap room, daycare room, bathroom on first floor, kitchen area, and play yard, The off-limits areas: The off limits areas for children will be the entire upstairs which is made inaccessible by child safety gating at the base of the stairs. (all upstairs, garage, back wood deck area, area outside white fences). Isolation: Nap Room Area in the (1st floor)
There are ample age appropriate toys and furnishings that are safe and in good repair. There are no pools, hot tubs or any other accessible bodies of water. All hazardous materials and toxins are kept out of the reach of children. The home has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The licensee Health and Safety training is completed and CPR and First Aid certificates are current and expires in APRIL, 2023. The licensee is in compliance with new immunization laws which pertain to day care providers. Per applicant, there are no firearms in the home. A copy of the mortgage statement was reviewed and shows control of property. The licensee's mandated reporter training is current and expires (FEB 2024). Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on DEC 2022. 2 Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2023
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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: CARTER, CHRISTINA
FACILITY NUMBER: 013422956
VISIT DATE: 01/24/2023
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The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Also, any adults moving into the home must be reported to Community Care Licensing prior to them moving in and all requirements must be met before the person lives in the facility. Licensee was reminded of Departments inspection authority, with our without any notice.

California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.
The licensee was also reminded that baby bouncers, exersaucers, johnny jumpers and similar items are not allowed in licensed day care.
Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov


There are no deficiencies cited. This report shall remain on file for 3 years. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2023
LIC809 (FAS) - (06/04)
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