334820670-9-21-2022-10-CC-SBRR-CJGN2F-20220921100441

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334820670
Report Date: 09/21/2022
Date Signed: 09/21/2022 10:04:53 AM

Document Has Been Signed on 09/21/2022 10:04 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	NELSON FAMILY CHILD CARE		FACILITY NUMBER:	334820670
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 6	CENSUS: 6	DATE:	09/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	07:08 AM
MET WITH:	Wendy Nelson, Licensee		TIME COMPLETED:	10:15 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 09/21/2022 at 7:08 AM Licensing Program Analyst (LPA) Susan Brewer arrived at the facility to conduct an annual inspection. LPA was granted entry by Licensee Wendy Nelson. LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: Present were the Licensee and 2 adult residents. Normal days and hours of operation are Monday- Friday, 6:00 AM to 5:30 PM OFF-LIMIT AREAS INCLUDE: 2^nd Floor, Kitchen, Laundry Room, Garage and Two side yards. The inspection consisted of reviews of the following domain: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio and Capacity, Personal Right. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. · The facility is operating within the licensed capacity and appropriate ratios. A census was taken of 6 children in care on 09/21/2022. · The Licensee is present in the home and has ensured that children in care are supervised. · When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children · A working telephone is present. · Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the Licensee Wendy Nelson, during this inspection on 08/21/2022. · All hazardous items are inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children. · Storage of poisons is inaccessible to children and locked on 09/21/2022. · There is a properly barricaded fireplace on 09/21/2022.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: NELSON FAMILY CHILD CARE	FACILITY NUMBER: 334820670
	VISIT DATE: 09/21/2022

NARRATIVE

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· No guns or weapons present as stated by the Licensee. Licensee Wendy Nelson, understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations.
· Stairs are barricaded at this time on 09/21/2022
· Home is clean and orderly, with heating and ventilation for safety and comfort on 09/21/2022.
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced and/ or appropriate supervision is present.
· Verification of control of property on file by mortgage statement 06/01/2008.
· Pediatric CPR and First Aid Card expire on 08/2023.
· Health & Safety Certificate - completed on file.
· Mandated reporter: General Not on file; AB1207 Child Care Expired: 01/2021
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 06/16/2022 4 children, went to the front of the home.
· There are no bodies of water on 09/21/2022. Licensee Wendy Nelson does own a spa, however the spa is emptied of water and has a locked cover. The licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Children’s files are complete on 09/21/2022.
· Employees files are NOT complete. Staff 1 and Staff 2, have not completed the California Child Abuse Mandated Reporter Training Part 1 and Part 2.

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.

For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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)/ (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

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: NELSON FAMILY CHILD CARE	FACILITY NUMBER: 334820670
	VISIT DATE: 09/21/2022

NARRATIVE

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Licensee Wendy Nelson, was reminded that all adults 18 and over living or working in the home, 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 Susan Brewer, discussed the safe sleep regulations with licensee Wendy Nelson 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 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

See LIC809D for cited deficiency for Type B citation on Mandated Reporter Training.

No Civil Penalty issued on 09/21/2022

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Wendy Nelson.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:	DATE: 09/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/21/2022 10:04 AM - It Cannot Be Edited

Created By: Susan Brewer On 09/21/2022 at 09:30 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: NELSON FAMILY CHILD CARE	FACILITY NUMBER: 334820670
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/21/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on facility record review, the licensee Wendy Nelson, did not comply with the section cited above in the licensee did not complete, Part 1 of the CA Child Abuse Mandated Reporter Training and Part 2, AB1207 exp. 01/2021 and the licensee did not ensure that Staff 1 and Staff 2, complete the California Child Abuse Mandated Reporter within 90 days of hire, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/21/2022
	Plan of Correction
1 2 3 4	The licensee Wendy Nelson, agrees to complete the required California Child Abuse Mandated Reporter Training and ensure that all current and newley hired employees, complete the required training and provide proof of training to the department on or before 10/21/2021, by mail, fax or e-mail.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Pauline Beschorner

LICENSING EVALUATOR NAME:

Susan Brewer

LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022

LIC809 (FAS) - (06/04)

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