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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343620505
Report Date: 07/29/2021
Date Signed: 08/02/2021 10:36:06 AM

Document Has Been Signed on 08/02/2021 10:36 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:TOTS OF LOVEFACILITY NUMBER:
343620505
ADMINISTRATOR:VANESSA GRANTFACILITY TYPE:
850
ADDRESS:5619 MARCONI AVENUETELEPHONE:
(916) 689-8687
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY: 24TOTAL ENROLLED CHILDREN: 0CENSUS: 17DATE:
07/29/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Sherrie MorrisTIME COMPLETED:
04:50 PM
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**NOTE: This is an Amended Report**

At 2:25 p.m. on Thursday, July 29th, 2021, Licensing Program Analyst (LPA) Karyn Guerra, and LPA Jeevun Birk-Miller met with Director, Sherrie Morris, for the purpose of a case management inspection. During the inspection, LPAs Guerra and Birk-Miller reviewed staff files and criminal record clearances of facility staff.

At 2:28 p.m., LPAs observed that Director, Sherrie Morris, and Staff, Lindsay McKain have criminal record clearances but are not associated to the facility. Director, Sherrie Morris, has been employed at the facility since March, 2021. Staff, Lindsay McKain, has been employed at the facility since May or June 2021.

At 3:00 p.m., it was observed that 2 out of 4 staff files were incomplete.


Title 22 deficiencies are cited on the subsequent pages of this report. Director acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided. Director's signature on this report acknowledges receipt of these rights. This report was reviewed with the Director. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days for parental review.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2021
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 07/29/2021 04:39 PM - It Cannot Be Edited


Created By: Karyn Guerra On 07/29/2021 at 03:27 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: TOTS OF LOVE

FACILITY NUMBER: 343620505

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 07/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/30/2021
Section Cited
CCR
101217(a)

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Personnel Records (a) The licensee shall ensure that personnel records are maintained on the licensee, administrator and each employee....This requirement was not met, as evidenced by:
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Director will complete staff files and will provide proof of completion to LPA by POC due date.
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Based on observations, Personnel Records were not complete for 2 out of 4 staff files reviewed. This is a potential risk to children in care.
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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:Seychelle De Luca
LICENSING EVALUATOR NAME:Karyn Guerra
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2021


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Document Has Been Signed on 08/02/2021 10:37 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 08/02/2021 10:19 AM


Created By: Karyn Guerra On 07/29/2021 at 04:01 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: TOTS OF LOVE

FACILITY NUMBER: 343620505

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 07/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/30/2021
Section Cited
CCR
101170(e)(1)

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Criminal Record Clearance. Prior to working or volunteering in a licensed child care facility, all individuals subject to a criminal record review shall request a transfer of a criminal record clearance from another facility or Trustline. This requirement was not met, as evidenced by:
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LPAs Guerra and Birk-Miller provided clearance transfer paperwork to Director. Director will submit completed transfer request with required supporting documents to LPA by POC due date.
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LPAs learned that Sherrie Morris and Lindsay McKain have a criminal record clearance but are not associated to this license. This poses an immediate risk to children in care. CIVIL PENALTY ASSESSED.
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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:Keven Peters
LICENSING EVALUATOR NAME:Karyn Guerra
LICENSING EVALUATOR SIGNATURE:
DATE: 08/02/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/02/2021


LIC809 (FAS) - (06/04)
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