343619040-2-7-2023-53-CC-SMAY-CNTT5B-20230207132515

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 343619040
Report Date: 02/07/2023
Date Signed: 02/07/2023 01:25:29 PM

Document Has Been Signed on 02/07/2023 01:25 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	YOUNG, MELISSA		FACILITY NUMBER:	343619040
ADMINISTRATOR:	YOUNG, MELISSA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 212-9649
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 15	DATE:	02/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Melissa Young		TIME COMPLETED:	01:40 PM

NARRATIVE

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On February 7, 2023, Licensing Program Analyst (LPA) Salene Mayberry met with Licensee Melissa Young for the purpose of an unannounced annual random inspection. Also present during the inspection was Licensee’s assistant/husband Brian Young. A review of the Facility Personnel Summary shows that all adults living and working in the home have criminal record clearances on file with Licensing office. Licensee stated that no new residents have moved into the home since licensure. LPA verified the annual fees are current. Capacity specified on the license was not met during today’s inspection. LPA observed 15 children present in the facility, ages 6, 6, 5, 5, 4, 4, 4, 4, 3, 3, 2, 2, 2, 1 and 1. During the visit 2 children were picked up, placing the facility back in compliance. Facility hours of operation are 6:00 am to 5:30 pm.

Licensee 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.

A health and safety inspection was conducted in all areas accessible to children. Upon entry, LPA observed the posting of the facility license, Emergency Disaster Plan, Earthquake Preparedness Checklist and Notification of Parent Rights. LPA also observed a facility roster and confirmed that fire drills are conducted at least once every six months. LPA verified the facility maintains a working phone, has a 3A40BC fire extinguisher, and functioning combined smoke and carbon monoxide detector. LPA observed that all hazardous and personal hygiene items are inaccessible to children in care. Licensee stated there are weapons in the home and LPA verified that all weapons and ammunition were stored according to Title 22 Regulations. The fireplace in the home is appropriately barricaded to prevent access by children.

Report continued on LIC809-C.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Salene Mayberry
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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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Document Has Been Signed on 02/07/2023 01:25 PM - It Cannot Be Edited

Created By: Salene Mayberry On 02/07/2023 at 12:27 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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: YOUNG, MELISSA	FACILITY NUMBER: 343619040
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/07/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(d)(2)

Staffing Ratio and Capacity

(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: (2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	LPA observed 15 children in care upon arrival the licensee did not comply with the section cited above by caring for 15 children without the additional children in care being in kindergarten and/or 6 years or older, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 02/08/2023
	Plan of Correction
1 2 3 4	Licensee will create a visual schedule/calendar that she will keep in the front that will be updated weekly and monthly with the kids attendance schedules. She will provide LPA with a copy by Thursday, 2/9.

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:

Bettina Engelman

LICENSING EVALUATOR NAME:

Salene Mayberry

LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: YOUNG, MELISSA	FACILITY NUMBER: 343619040
	VISIT DATE: 02/07/2023

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The outdoor play space for the facility is the front driveway and cul-de-sac. Licensee uses cones and 100% supervision when children are playing outside. In the backyard, LPA observed an above ground pool. There is a white metal fence that is at least five feet high and constructed so it is not obscuring the pool from view. LPA also observed that the pool gate swings away from the pool, is self-closing and self-latching. In addition, LPA walked down the fence line and pulled on the fence to observe the sturdiness. The fence extends all the way to the shed. There is an additional fence installed between the shed and the wooden perimeter fence, making the entire pool area inaccessible to children in care from all sides of the yard.

Off-Limit areas are: entire upstairs, garage, laundry room, downstairs bedroom and back yard. Licensee acknowledged that children are never allowed in any off-limit areas. Off limit areas will remain inaccessible by gates, locks, safety latches and supervision. Licensee understands they must ensure the safety latches are not broken.

LPA reviewed 15 children’s files and 2 staff files. Of the 15 files reviewed only 4 had incomplete files. LPA discussed the need to make sure that all files are updated and contain all required Licensing documents. Licensee will provide LPA with missing documents.

Current in person EMSA CPR and First Aid certification was verified and expires 4/24/23. AB1207 Mandated Reporter Training was also verified and expires 2/2/24. LPA discussed the requirement to renew the mandated reporter training every two years and provided the Mandated Reporter training website: www.mandatedreporterca.gov.

There are currently no children enrolled that require Incidental Medical Services (IMS). IMS was discussed and Licensee understands that when any IMS is provided, a Plan for Providing IMS must be submitted to Licensing.

Report continued on LIC809-C.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Salene Mayberry
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: YOUNG, MELISSA	FACILITY NUMBER: 343619040
	VISIT DATE: 02/07/2023

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LPA observed copies of the LIC9227 Individual Sleeping Plan, for infants under 12 months. LPA did not observe a sleep log during today’s visit. Licensee advised that she has a nap log, but she believes her daughter accidentally took the folder to school. Licensee will make a temporary one for use today and will provide LPA with a copy this afternoon. LPA and Licensee discussed the Safe Sleep requirements and the need to keep her long in a place out of reach of children to prevent this from happening again. LPA also provided Licensee with 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.

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

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.

Finally, Licensee was encouraged to the visit the Department's website at www.cdss.ca.gov for information regarding childcare updates, forms, regulations and legislation pertaining family childcare homes.

A Type A deficiency was cited on the subsequent page (LIC809-D) of this report. Upon receipt of Type A citations, the facility shall post and provide copies of the LIC809-D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. The facility must also keep a signed “Acknowledging Receipt of Licensing Reports” (LIC9224) in each child's file.

An Exit interview conducted, and the report was reviewed with Licensee. LPA provided Licensee with a copy of the report and posted a notice of site visit. Licensee understands the Notice must remain posted for 30 days and that a failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Salene Mayberry
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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