343618629-12-7-2023-03-CC-SMAX-CXSTZQ-20231121141042

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343618629
Report Date: 11/21/2023
Date Signed: 12/07/2023 01:30:52 PM

Document Has Been Signed on 12/07/2023 01:30 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	TENNELL, ARLENE		FACILITY NUMBER:	343618629
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 9	DATE:	11/21/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	12:05 PM
MET WITH:	Arlene Tennell		TIME COMPLETED:	02:45 PM

NARRATIVE

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On November 21st, 2023 Licensing Program Analysts (LPAs) Soleil Marx and Stephanie Piring met with Licensee, Arlene Tennell, for an unannounced annual / one year inspection. During the inspection there was a census of nine children in care being supervised by the licensee. All individuals subject to criminal background review have obtained a criminal record clearance. Facilities hours of operation are Monday through Friday 07:00 AM to 05:30 PM.

A health and safety inspection was conducted in the areas accessible to children. Off limit areas include: master bed/bath, daughters room, dining room, garage, and both side yards. LPAs observed a working telephone, functioning smoke and carbon monoxide detector, and a 2A10BC fire extinguisher within the home. LPAs observed home was safe, orderly. LPAs observed a variety of age-appropriate toys within the home. Fireplace within the home is barricaded to meet regulation. Licensee understands that if there are any poisons in the home, all poisons must be locked with a key lock or combination lock. Licensee stated there are no firearms on the premises.

LPAs observed a body of water accessible to children in care. Licensee has an above ground pool in the backyard approximately 4 feet deep with water and 18 feet wide, surrounded by a partial fence that was broken and propped open by a brick. The fence is not in compliance with Title 22 regulations and does not surround the entirety of the pool.

LPAs observed all required postings, a children's roster and fire drill log with drills documented and conducted every six months. LPAs reviewed records of children’s files and staff files, all which contained the required documentation. Licensee has current EMSA approved pediatric CPR/First Aid training, which expires 04/2024. Licensee understands both CPR and mandated reporter training's’ must be completed every two years.

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: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TENNELL, ARLENE	FACILITY NUMBER: 343618629
	VISIT DATE: 11/21/2023

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LPAs discussed the safe sleep regulations with licensee 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 [or facility representative] 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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.To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Based on today's inspection, two type A deficiencies are being cited on 809-D.Licensee was informed that this report dated 11/21/2023 documents two Type A citation which shall be posted for 30 consecutive days. The Licensee shall also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Licensee has been provided with appeal rights.

During the exit interview, the licensee, Arlene Tennell, confirmed that there are no Registered Sex Offenders living in the home/facility and LPA completed the RSO profile in FAS. Exit interview conducted and report was reviewed with the licensee, Arlene Tennell . A notice of site visit was given and must remain posted for 30 days. Appeal Rights Provided.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 11/21/2023 02:10 PM - It Cannot Be Edited

Created By: Soleil Marx On 11/21/2023 at 01:26 PM

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
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TENNELL, ARLENE	FACILITY NUMBER: 343618629
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(c)

Staffing Ratio and Capacity

(c) The total licensed capacity for a Small Family Child Care Home shall not exceed eight children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above by not operating within the capacity of her license of 8 by having 9 children in care, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 11/22/2023
	Plan of Correction
1 2 3 4	Licensee stated will not exceed the capacity of 8 by having her grandson stay home when needed. LPA will conduct a return visit to clear the POC.

Type A

Section Cited

CCR

102417(g)(5)

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above by not making a body of water inaccessible to children in care, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 11/22/2023
	Plan of Correction
1 2 3 4	Licensee stated she will drain, dismantle, and remove the above ground pool from the backyard. License stated she will consult with licensing on meeting title 22 fencing requirements prior to adding any bodies of water to the premises. LPA will conduct a return visit to clear the POC.

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:

Natalie Dunaway

LICENSING EVALUATOR NAME:

Soleil Marx

LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC809 (FAS) - (06/04)

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