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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423862
Report Date: 03/17/2023
Date Signed: 03/17/2023 12:26:11 PM

Document Has Been Signed on 03/17/2023 12:26 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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:TARVER, CHRISTAFACILITY NUMBER:
013423862
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
03/17/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Christa TarverTIME COMPLETED:
12:30 PM
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On 03/17/2023 at 10:00 am Licensing Program Analyst (LPA) Diana Campos arrived for an Announced Pre licensing Inspection. Present for this inspection was applicant Christa Tarver, her Spouse, and her infant child. Licensee's adult son, and four minor children also reside in the home but were not present during the inspection. The home was toured with the applicant to conduct a health and safety inspection. Applicant states the hours of operation for day care will be Monday through Sunday, 6:00am to 5:00am.

The home is a three story home within a gated community. The first floor consists of the kitchen, living room, and storage closet. The second floor consists of two bedrooms, a living room which will be used as the day care room, one bathroom and a small patio which is connected to the day care room by sliding doors. The third floor consists of two bedrooms and one bathroom. The home is neat and clean with heating and ventilation for safety and comfort.
ON LIMITS: Living room/play room, bathroom and small patio on the second floor. The isolation area will be in the play room.
OFF LIMITS: The entire first and third floors as well as the two bedrooms to the left of the stairs on the second floor. All off limit areas will be inaccessible by closed and/or locked doors and visual supervision. The applicant was advised to contact Licensing, so that an inspection can be completed prior to changing an off limits area to on limits.

The outdoor play area will be the small patio on the second floor where 100% visual supervision is required. Applicant states that there is a small play area within the gated community that can be used for outdoor play. There are ample age appropriate toys which are observed to be safe, clean and in good repair. There are no pools, hot tubs or any other bodies of water.
***Continued on LIC 809C..
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: TARVER, CHRISTA
FACILITY NUMBER: 013423862
VISIT DATE: 03/17/2023
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No hazardous materials or toxins were observed to be accessible to children today. Knives were stored in an upper kitchen cabinet. The home has a fully charged 2A10BC fire extinguisher, working dual unit carbon monoxide and smoke detectors, and working telephone. Heater vents are located on the wall near the ceiling. There are two small dogs in the home. Per applicant, there are no firearms in the home.

The applicant’s health and safety training has been completed, and First Aid/CPR certificate is current and expires on 2/22/2025. A copy of the lease agreement has been reviewed and shows control of property. The applicant has provided proof of the required immunizations, and the required mandated reporter training was completed on 8/28/2022. Safe Sleep practices, and Effects of Lead Exposure and testing requirements information brochures were discussed and provided.


Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.
LPA discussed the safe sleep regulations with applicant 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 applicant 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

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
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: TARVER, CHRISTA
FACILITY NUMBER: 013423862
VISIT DATE: 03/17/2023
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To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The home is recommended for licensure as of today.

Exit interview conducted and report was reviewed with the applicant Christa Tarver.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
LIC809 (FAS) - (06/04)
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