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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423891
Report Date: 08/16/2023
Date Signed: 08/16/2023 11:28:40 AM

Document Has Been Signed on 08/16/2023 11:28 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:WALKER, MEGANFACILITY NUMBER:
013423891
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/16/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Megan WalkerTIME COMPLETED:
11:35 AM
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On 08/16/23 at 8:20 AM, Licensing Program Analyst (LPA) Diana Campos arrived at the home for an announced prelicensing, change of location, inspection. LPA met with Megan Walker. Present during the inspection was licensee's spouse. There were no children present during today's inspection.

LPA toured the home with the licensee. The home is a single story home, which consists of the living room, dining area, kitchen, 2 bedrooms, 1 bathroom, laundry room, and garage. The home is neat and clean with heating and ventilation for the safety and comfort of children in care. The on limit areas include the living room, dining area, kitchen, laundry room, bathroom and backyard (kitchen and laundry room for walk thru to the backyard and bathroom). The off limit areas include the licensee's bedroom to the left of dining room, the bedroom to the right of living room, the laundry room (other than walking thru to the yard), the garage, basement and storage shed in the back yard. These areas are made inaccessible by closed and/or locked doors and visual supervision at all times. The isolation area will be in the kitchen away from other children in care. The outdoor play area is the fenced backyard, children will only use the area under the canopy and the seating deck area with 100% visual supervision. There is an ample supply of age appropriate toys and activities accessible to children, and LPA observed that they are in good condition. There is a fully charged 3A40BC fire extinguisher, working combination smoke and carbon monoxide detector unit, telephone and fully stocked first aid kits. The fireplace is blocked off but is not functional, and there is one small heater vent which is blocked off, to prevent access by children. LPA did not observe any bodies of water, hazardous items or toxins accessible to children today. Per the licensee, there are no firearms in the home. Licensee has a current CPR and first aid certificate which expires on 11/2023. Licensee has current proof of completion of the required mandated reporter training, dated 11/2021. LPA reviewed the lease, and it shows control of property.
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SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2023
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, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: WALKER, MEGAN
FACILITY NUMBER: 013423891
VISIT DATE: 08/16/2023
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Licensee 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

LPA reviewed with licensee, 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.

On this date, 08/16/2023 the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

LPA discussed the safe sleep regulations with licensee, or and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

APPLICANT LEASES THE HOME: The licensee provided proof of control of property.

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

DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023
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: WALKER, MEGAN
FACILITY NUMBER: 013423891
VISIT DATE: 08/16/2023
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APPLICANT LEASES THE HOME AND HAS LANDLORD CONSENT: Because the licensee leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS: Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (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.

Licensee was reminded that she must contact the licensing department prior to changing an off-limit area to on-limits so that an inspection can be completed.

This home is recommended for licensing. The capacity for the license will be listed as 8, but the licensee was advised that a maximum of 6 children can be in care without the consent of the landlord. LPA reminded the applicant that compliance with all Title 22 regulations and applicable Health and Safety regulations, must be maintained at all times. This report shall remain on file for 3 years. Exit interview conducted with Licensee Megan Walker.

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

DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2023
LIC809 (FAS) - (06/04)
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