197495019-2-9-2022-30-CC-ARIR-CBGVYK-20220209155116

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197495019
Report Date: 02/07/2022
Date Signed: 02/09/2022 03:51:28 PM

Document Has Been Signed on 02/09/2022 03:51 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	DOLBERRY FAMILY CHILD CARE		FACILITY NUMBER:	197495019
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	02/07/2022
TYPE OF VISIT:	Office	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Darryl Dolberry, Applicant		TIME COMPLETED:	11:30 AM

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INFORMAL MEETING
An informal office meeting was scheduled virtually via Microsoft Teams in the El Segundo Child Care Regional Office on February 07, 2022.

The meeting attendees are as follows:
Maureen Neal, Licensing Program Manager
Adrian Risher, Licensing Program Analyst
Darryl Dolberry Applicant
Torrey Barnette, Applicant's Aunt/Current Licensee for home address

The purpose of this meeting is to discuss the Department's expectations pertaining to the responsibilities as a licensee of a family childcare home.

LPM began the meeting with introductions of licensing staff and purpose of meeting.

LPM inquired about the email that was submitted to the department because prior to the TEAMS meeting Ms. Barnette was replying to LPM regarding the upcoming meeting. Applicant Mr. Dolberry informed CCL that the email address belonged to his mother Marvis Dolberry. LPM informed Mr. Dolberry as the applicant that he should have an email address that belonged to him since he will be the licensee. LPM inquired if he intended to have his mother Ms. Dolberry assist him in the daycare and if he was aware that CCL took legal action against the license that lead to revocation of the FCC license at the very same address that is licensed by Ms. Barnette and where he has applied for a license.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2022

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: DOLBERRY FAMILY CHILD CARE	FACILITY NUMBER: 197495019
	VISIT DATE: 02/07/2022

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Mr. Dolberry stated that he had no plans to utilize Marvis Dolberry as an assistant and he was unaware of the actions that led to his mother’s revocation of license. LPM informed him that Marvis Dolberry’s license was revoked based on a child wandering away from the facility, child left unsupervised outdoors, failure to obtain fingerprint for him, his sister and an assistant, expired CPR for the assistant, knives and chemicals accessible to children. LPM informed applicant should he decide to have Marvis Dolberry assist and/or come to the home during operation hours she must obtain a fingerprint clearance.

Mr. Dolberry informed LPM that Torrey Barnette will serve as a mentor and assistant as needed. LPM informed applicant that while Ms. Barnette could be a great resource, he should always contact his assigned LPA Ms. Risher with any questions or concerns to ensure he receives accurate information. In situations where Ms. Risher is not informed, she will elevate the concern to LPM for further evaluation. Applicant was asked if he was the current homeowner, applicant verified that he is.

Mr. Dolberry verified the daycare hours as 24 hours 7 days a week and based on parent's needs. The primary daycare hours will be 6:00am to 6:00pm. LPM recommended that the applicant create a contract for the parents to sign that will include overnight care policies and procedures. Mr. Dolberry informed CCL that Torrey Barnette currently cares mostly for family members and 8 of the children from her daycare will enroll with Mr. Dolberry and the remaining 8 children will enroll in a daycare operated by Ms. Barnette’s niece which is not located in 90047.

LPM confirmed that rdolberry@yahoo.com email address belongs to Marvis Dolberry. Applicant provided an updated email address d_dolberry1@yahoo.com

Applicant stated he currently works 2 jobs. The first one is a graveyard shift 11:30pm to 7:00am Friday, Saturday and Sunday and a day job from 8:00am to 3:00pm Monday thru Friday. Applicant stated his plan is to leave both jobs once he receives his license for the daycare.

As a reminder to the applicant, he is to adhere to the 80/20 rule meaning that 80% of time he is expected to be at the FCC and allowed 20% to be away.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: DOLBERRY FAMILY CHILD CARE	FACILITY NUMBER: 197495019
	VISIT DATE: 02/07/2022

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Family Child Care Home- Your responsibility as a licensee as outlined in Title 22 section 102417(a).

LPM Neal reminded Mr. Dolberry of the following according to Title 22- The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.

Mr. Dolberry was reminded as a licensee it’s his primary responsibility to ensure the day to day operation of the Family Child Care Home. Mr. Dolberry stated he understood the expectations and willing to comply.

The meeting adjourned.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2022

LIC809 (FAS) - (06/04)

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