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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629266
Report Date: 07/08/2022
Date Signed: 07/08/2022 02:27:59 PM

Document Has Been Signed on 07/08/2022 02:27 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:JEAN, SHERLINE FAMILY CHILD CAREFACILITY NUMBER:
376629266
ADMINISTRATOR:SHERLINE JEANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 892-6581
CITY:SAN DIEGOSTATE: CAZIP CODE:
92113
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/08/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Sherline JeanTIME COMPLETED:
09:45 AM
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On 7/8/22 at 9:00am, Licensing Program Analyst (LPA) Cindy Meier conducted an announced Change of Location inspection with applicant, Sherline Jean. The purpose of the inspection is to ensure the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This two story, four bedroom, three bath home was toured and inspected. The hours of operation are Monday through Saturday, 6:00 a.m. to 6:00 p.m.

On 1/12/2022 a fire clearance was granted for fourteen (14) children. Applicant will utilize the following downstairs areas for child care: child care room (bedroom #1), living room, dining room, and bathroom. Off Limit areas downstairs includes kitchen. All of upstairs is Off Limits and includes master bedroom, master bathroom, bathroom #2, bedroom #3 and bedroom #4. The stairs leading to these areas are barricaded by a safety gate. Applicant will utilize the fenced back yard for outdoor activities. LPA informed applicant to ensure children are supervised at all times during outdoor activities. Applicant stated there are no bodies of water and LPA did not observe any bodies of water during the inspection.

The fire extinguisher is rated 2A10B:C and is located in the kitchen, smoke and carbon monoxide detectors meet requirements and are operational. Detergents, cleaning compounds, and medicines are inaccessible to children in care and poisons are to be locked away. There is no fireplace on the premises. Children’s toys and play equipment are available. The applicant has a working cell phone. Applicant stated there are no firearms, other weapons or ammunition in the home.

Applicant maintains documentation of proof of control of property for review by the Department. Applicant’s Mandated Reporter AB1207 training expires on 9/13/2023. Applicant completed 8 hours of preventative health which included nutrition on 3/23/2019 and completed Lead Training on 2/16/2022. Pediatric CPR and First Aid certifications expire on 6/2023. Immunization records per SB792 were reviewed and met regulations. Required documents are posted.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE: DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/08/2022
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: JEAN, SHERLINE FAMILY CHILD CARE
FACILITY NUMBER: 376629266
VISIT DATE: 07/08/2022
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Applicant and adult residents in the home have criminal record clearances and/or exemptions on file.
Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 advised applicant that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. Applicant states they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes.

Applicant does not plan on providing Incidental Medical Services (IMS) to clients at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm. LPA discussed California Megan's Law and provided licensee the following website: www.meganslaw.ca.gov.

A Resource Packet was reviewed with the applicant including information on the following: PIN20-24-CCP Safe Sleep Regulations, lead exposure, SIDS, shaken baby, child abuse reporting, community resources, children’s records, facility records, required postings, immunizations, unusual incident report, facility roster, car seat law, visual for ratio/capacity, fire/disaster drill log. Applicant was also informed the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care. LPA discussed Guardian with
applicant: https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: JEAN, SHERLINE FAMILY CHILD CARE
FACILITY NUMBER: 376629266
VISIT DATE: 07/08/2022
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LPA discussed the safe sleep regulations with applicant 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 applicant 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.

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

LPA discussed the maximum capacity for a large family child care home: twelve (12) children, with a qualified assistant; no more than four (4) infants and the remaining children are over 2 years of age (infants mean any children under 24 months); or fourteen (14) children, with a qualified assistant; no more than three (3) infants and one child is at least six (6) years and one child is in and attending kindergarten or elementary school. Provider’s children under the age of ten (10) who live in the home are included in the child care capacity. When there is no qualified assistant, fourteen (14) years of age or older present, the capacity reverts back to the requirements for a Small Family Child Care Home. If the assistant is under the age of eighteen (18), the assistant must not be left alone with children at any time.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.
To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. San Diego Regional Office Duty Line was provided: (619) 767-2248.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: JEAN, SHERLINE FAMILY CHILD CARE
FACILITY NUMBER: 376629266
VISIT DATE: 07/08/2022
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Southern California Child Care Advocate information was provided, and applicant was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

A Large Family Child Care Home license may be issued upon final file review. LPA Meier explained inspection report to applicant, applicant stated she understood. Exit interview conducted and report was reviewed with the applicant, Sherline Jean.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2022
LIC809 (FAS) - (06/04)
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