364846684-3-10-2025-09-CC-JGIE-DEMMN6-20250310094501

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 364846684
Report Date: 03/10/2025
Date Signed: 03/10/2025 09:45:07 AM

Document Has Been Signed on 03/10/2025 09:45 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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME:	BROOKS FAMILY CHILD CARE		FACILITY NUMBER:	364846684
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	03/10/2025
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:30 AM
MET WITH:	Veronica Brooks		TIME VISIT/ INSPECTION COMPLETED:	10:00 AM

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 date and time listed above, Licensing Program Analyst (LPA) Justin Giese made an unannounced visit for the purpose of conducting a Licensee initiated case management visit. Licensee is seeking a capacity increase to that of a Large Family Childcare home. Fire clearance was granted on 02/20/2025. LPA met with Licensee, Veronica Brooks. LPA toured the facility, inside and out and observed and/or discussed the following: At time of visit no children were in care. · A working telephone is present · Appropriate fire extinguisher, smoke detector and carbon monoxide detector is present and were tested during this inspection · Two story home, stairs barricaded. · Fireplace is covered · All hazardous items are inaccessible, this includes: detergents, cleaning compounds, medications and other items which could pose a danger to children · Storage of poisons are inaccessible to children and locked · No Firearms are stored at this facility as stated by Licensee. The Licensee understands that all guns, weapons and ammunition must be key-locked separately and made inaccessible per Title 22 regulations · 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 or appropriate supervision is present · Verification of control of property on file · Control of Property on file · Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted · Pediatric CPR and First Aid Card expires 12/04/2026 · Health & Safety Certificate completed and on file

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: BROOKS FAMILY CHILD CARE	FACILITY NUMBER: 364846684
	VISIT DATE: 03/10/2025

NARRATIVE

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· There are no bodies of water, at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.

Reminders
- Current facility’s phone numbers must be on file at all times.
- Documentation of fire & earthquake drills are to be conducted every six months
- Responsibilities of being a mandated reporter
- Baby walkers, bouncy seats, exersaucers and other similar items are prohibited
- The licensee is urged to visit the U.S. Consumer Product Safety Commission web page at www.cpsc.gov to ensure that equipment purchased for the day care has not been recalled.
- Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited (Type A), a copy of the licensing report (LIC809/LIC9099) must also be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.
- Access to forms & Regulations for Family Child Care Homes online at www.ccld.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care

- Please subscribe and email: childcareadvocatesprogram@dss.ca.gov 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

- The Duty Officer is available to answer questions Monday – Friday 8am to 5pm at 951-782-4200

The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO09@dss.ca.gov

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025

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
RIVERSIDE CC RO, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: BROOKS FAMILY CHILD CARE	FACILITY NUMBER: 364846684
	VISIT DATE: 03/10/2025

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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/.

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-andresources/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.

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.

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.

Capacity increase of a Large Family Daycare home will be granted.

An exit interview was conducted, and report was reviewed with Licensee.

A notice of site visit was given and must remain posted for 30 days

SUPERVISORS NAME: Gilbert Sena
LICENSING EVALUATOR NAME: Justin Giese
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025

LIC809 (FAS) - (06/04)

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