364811808-10-18-2022-09-CC-DBRL-CKBRVF-20221018132128

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364811808
Report Date: 10/18/2022
Date Signed: 10/18/2022 01:21:42 PM

Document Has Been Signed on 10/18/2022 01:21 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	SINCLAIR FAMILY CHILD CARE		FACILITY NUMBER:	364811808
ADMINISTRATOR:	SINCLAIR, NANCY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 395-9597
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91762
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 1	DATE:	10/18/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Nancy Sinclair		TIME COMPLETED:	01:35 PM

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 the above date and time Licensing Program Analyst (LPA) Diana Brasel arrived at the facility to conduct an annual inspection. LPA was granted entry by Licensee, at time arrival 1 child was observed. LPA toured the facility, inside and out, reviewed records, and observed and/or discussed the following: Normal days and hours of operation are: Monday- Friday 6:00 am - 7:00 pm. OFF-LIMIT AREAS INCLUDE: Entire upstairs and garage. · The inspection consisted of reviews of the following domains: Physical Plant Care and Supervision Records Facility Administration Staffing Ratio and Capacity Personal Rights · The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. Deficiencies cited this visit. · The facility is operating within the licensed capacity and appropriate ratios · 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 during this inspection. · All hazardous items are inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SINCLAIR FAMILY CHILD CARE	FACILITY NUMBER: 364811808
	VISIT DATE: 10/18/2022

NARRATIVE

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· Storage of poisons is inaccessible to children and locked
· There is a properly barricaded fire place
· No guns or weapons present as stated by the Licensee.
· Stairs are barricaded at this time
· Home is clean and orderly, with heating and ventilation for safety and comfort
· 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
· Pediatric CPR and First Aid Card expired 09/2019 - The licensee stated, the last time she checked classes were not available. The licensee stated, she will register for a class and update her card. Health & Safety Certificate - completed 04/10/2005 Mandated reporter: General not taken. Child Care Provider taken 05/14/2019, has expired. The licensee stated, she will take the courses and provide current certificate. Fire clearance: 04/13/2000
Documentation of fire & earthquake drills to be conducted every six months: Last drill on 06/092/2022.
There is an in-ground pool and located in the backyard. The gate is self-latching and self-closing, the latch was tested at time of visit. The fencing is wrought iron and meets Title 22 regulations. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Clean, safe and age appropriate toys
· Each child’s file contains a copy of the emergency information card with required information
FCC PROVIDING IMS

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 Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 For FCCHs: Incidental Medical Services (IMS) policy was discussed.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

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 ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SINCLAIR FAMILY CHILD CARE	FACILITY NUMBER: 364811808
	VISIT DATE: 10/18/2022

NARRATIVE

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· 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.

· LPA 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-and-resources/safe-sleep as an additional resource. LPA also informed licensee [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.

· 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.
· Please subscribe at www.childcareadvocatesprogram@dss.ca.com to receive Department updates. They will be sent directly to your e-mail account once you have set up an account. This website can also be accessed through www.ccld.ca.gov

See LIC 809D for cited deficiencies.

An updated LIC 279 was obtained at time of visit.

An exit interview conducted, and appeal rights were reviewed with the licensee.

A notice of site visit was given and must remain posted for 30 days, failure to comply with posting requirements shall result in an immediate civil penalty of $100.

A copy of this report was provided to the licensee on this date and must be made available to the public upon request for the next 3 years.

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Diana Brasel
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/18/2022 01:21 PM - It Cannot Be Edited

Created By: Diana Brasel On 10/18/2022 at 12:56 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
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: SINCLAIR FAMILY CHILD CARE	FACILITY NUMBER: 364811808
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/18/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPAs observation of the licensees expired CPR & First Aid card, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/28/2022
	Plan of Correction
1 2 3 4	The licensee has agreed to submit proof of enrollment into an approved EMSA CPR & First Aid course, no later than 10/28/2022. Proof of enrollment into the course will be submitted to LPA. Upon completion of the course the licensee has agreed to provide a copy of the obtained current CPR card.

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:

Gilbert Sena

LICENSING EVALUATOR NAME:

Diana Brasel

LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022

LIC809 (FAS) - (06/04)

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