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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343624088
Report Date: 02/20/2025
Date Signed: 02/20/2025 12:25:28 PM

Document Has Been Signed on 02/20/2025 12:25 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
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:PRINCE, YULIWIANAFACILITY NUMBER:
343624088
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
02/20/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:00 AM
MET WITH:YuliwianaTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On February 20, 2025, Licensing Program Analyst (LPA) Kyrsten Williams conducted an unannounced annual inspection and met with the Licensee, Yuliwiana Prince. Licensee has also requested to increase capacity from a small family child care to a large family child care. Licensee’s two adult children were also present in the home. Census included six children in care being supervised by licensee. Facility hours of operation are Monday through Friday 7:15 AM - 5:15 PM.

LPA conducted a health and safety inspection and observed that the facility is clean, safe, sanitary, and in good repair with ventilation. LPA observed the required documents were posted where visible to parents. The facility has equipment and toys safe for children. LPA observed that there were no hazardous items—such as cleaning compounds, medications, or sharp objects—accessible to children. The fire extinguisher appeared to be in working condition and accessible. LPA observed the smoke and carbon monoxide detectors are functioning. LPA observed the fireplace is properly barricaded to prevent access. LPA observed the front play yard is fenced, and licensee acknowledges in areas that are not fenced 100% supervision is required. The licensee stated there are no weapons, poisons, or bodies of water on the premises. Off-limit areas include all bedrooms, backyard, garage, and patio area. Licensee acknowledges childcare children may never enter off-limit areas. A fire clearance was granted on 02/19/2025.

LPA observed a current children's roster, fire drill log, and 15-minute sleep check logs for infants in care. LPA reviewed children’s files and observed that all the required documentation was present in each child's file. LPA reviewed staff and facility files and observed the required documentation. LPA observed the CPR/First Aid certificate is current and expires in December 2025. LPA observed the Mandated Reporter training certificate is current and expires in December 2025. The licensee was reminded CPR/First Aid training and Child Care portion of Mandated Reporter Training must be completed every two years.

LPA discussed CCR Regulation 102416.5 regarding staffing Ratio and Capacity for a large license.
LPA discussed personnel requirements and records outlined in CCR Regulations 102416 and 102416.1.
Licensee understands that when an assistant is not present, she must comply with the capacity and ratio requirements for a Small Family Child Care Home.
PAGE 1. REPORT CONTINUES ON LIC809-C
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Kyrsten Williams
LICENSING EVALUATOR SIGNATURE: DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/20/2025
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: PRINCE, YULIWIANA
FACILITY NUMBER: 343624088
VISIT DATE: 02/20/2025
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All individuals subject to criminal background review have obtained a criminal record clearance. The 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.
During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA discussed the safe sleep regulations with the licensee 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

The licensee was informed of the www.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.
PAGE 2. REPORT CONTINUES ON LIC809-C
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Kyrsten Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
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: PRINCE, YULIWIANA
FACILITY NUMBER: 343624088
VISIT DATE: 02/20/2025
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Effective today, 02/20/2025, the facility is approved for a large capacity to serve 12 children (when there is an assistant present) with no more than 4 infants or capacity of 14 children when 1 child in kindergarten or elementary school and 1 child at least age 6 and a maximum of 3 infants. Infants are children under the age of two years.

This facility evaluation report was reviewed and discussed with the licensee, Yuliwiana Prince. No deficiencies are cited today. A Notice of Site Visit was provided and should remain posted for 30 days for parental review.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Kyrsten Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2025
LIC809 (FAS) - (06/04)
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