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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409492
Report Date: 05/16/2024
Date Signed: 05/16/2024 11:30:50 AM

Document Has Been Signed on 05/16/2024 11:30 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:SCOTT-JEFFERSON, MAKAYLAFACILITY NUMBER:
073409492
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 4DATE:
05/16/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Makayla Scott-JeffersonTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 05/16/2024 at 9:00 AM, Licensing Program Analyst (LPA) Christina Watts conducted an announced case management – licensee initiated for Makayla Scott-Jefferson's small family child care home. The licensee has requested to change their capacity from 6 to 8 children. LPA met with licensee and guided analyst on a tour of the facility. During today's inspection, there were 4 children in care (2 infants and 2 preschool aged children) and 4 children enrolled. Also present during inspection was licensee's 1 year old child. Family members residing in the home are licensee and licensee's 1 year old child. Licensee has Criminal Record Clearance. Facility hours of operations are Monday - Friday from 6:00 AM - 6:00 PM.

Licensee completed her Pediatric CPR/First Aid certificate which expires 09/2025 and Mandated Reporter certificate which expires 11/2025. Licensee has documentation maintained for Measles, Pertussis Immunization's, Influenza Opt-Out statement for the current flu season. The licensee provided proof of control of property. Because the licensee rents/leases the home, proof of landlord notification is required. The licensee submitted to licensing the Property Owner/Landlord Notification form (LIC 9151) that the licensee confirms was provided to the property owner/landlord. The licensee obtained a signed Property Owner/Landlord Consent form. There is a working telephone in the home.

This is a two story apartment that comprises of 3 bedrooms, 2 bathrooms, Living Room, Kitchen, Dining room, and backyard.
Areas on limits: Living Room, first floor bedroom, first floor bathroom, office (2nd bedroom), central and right side of backyard. Licensee will be utilizing the living room as the main room for her day care area.
Off-Limit Areas: Master bedroom, master bathroom, kitchen, dining room, and left side of backyard
Isolation Area: Office (first floor 2nd bedroom)

*CON'T ON PAGE 2*

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2024
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: SCOTT-JEFFERSON, MAKAYLA
FACILITY NUMBER: 073409492
VISIT DATE: 05/16/2024
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*PAGE 2*

Per licensee, there are no firearm in the home. LPA observed a wall furnace which is attached to the wall and made inaccessible to children in care. LPA observed a fully charged 2A10BC fire extinguisher, working dual smoke and carbon monoxide detector. There are stairs in the home that are made inaccessible to children. Medicines, cleaning products, sharp objects are stored inaccessible to children. LPA reminded that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family child care homes.

OUTDOOR SPACE: LPA toured the outdoor area. LPA observed a fully fenced and safe backyard for children in care. LPA also observed age appropriate toys for children to play with. On the right side of facility, there is a wooden gate that will kept locked at all times. LPA did not observe any bodies of water in the backyard. Children will be using the backyard and a park near the facility for outdoor activity. LPA discussed with license that there needs to be 100% supervision when outside of the facility. Licensee stated they will not provide transportation for children and understands that children cannot be left alone, unattended in parked vehicles.



LPA discussed and reminded licensee day care needs to be operated within the limitations and capacity of a Small Family Child Care Home with regards to ratios and that Licensee has to be present in the day care for 80% of the operation hours. All documents have been reviewed for the increase of capacity application.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at:https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

LPA provided the main office number for the Oakland Regional Child Care office (510) 622-2602. Licensees are to call and report injuries or unusual incidents within 24 hours of knowledge of occurrence. Licensees are to review the form (LIC 624B) to follow up in writing within 7 days of the injury/unusual incident.

Licensee was reminded that all adults 18 and over living or working in the home, 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.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
LIC809 (FAS) - (06/04)
Page: 2 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: SCOTT-JEFFERSON, MAKAYLA
FACILITY NUMBER: 073409492
VISIT DATE: 05/16/2024
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*PAGE 3*

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Effective as of 05/16/2024, change of capacity application has been approved.

During today's inspection, there were no violation observed.

Exit interview conducted and report was reviewed with the licensee, Makayla Scott-Jefferson. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
LIC809 (FAS) - (06/04)
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