376629897-5-20-2024-20-CC-SWIS-D5FU8X-20240520152215

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629897
Report Date: 05/20/2024
Date Signed: 05/20/2024 03:22:25 PM

Document Has Been Signed on 05/20/2024 03:22 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	SEMEXANT, JOHNSON FAMILY CHILD CARE		FACILITY NUMBER:	376629897
ADMINISTRATOR/ DIRECTOR:	JOHNSON SEMEXANT		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 381-8746
CITY:	SPRING VALLEY	STATE: CA	ZIP CODE:	91977
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	05/20/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:15 PM
MET WITH:	Applicant, Johnson Semexant		TIME VISIT/ INSPECTION COMPLETED:	03:30 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	1.On 05/20/2024 at 1:15pm. Licensing Program Analysts (LPAs) Shannan Williams and Michelle Hood conducted an announced Pre-Licensing Change of Location inspection for a new Small Family Child Care Home. The applicant applied for a large however the applicant does not qualify for a large at this time. LPAs met with applicant, Johnson Semexant, who provided a tour of the home. A review of the Facility Personnel Report Summary indicates 2 adults living in the home have criminal record clearance. Per the applicant, there are 3 minors living in the home. Per the applicant, operation hours will be Monday through Friday, 7:00 AM- 11:00 PM. The applicant plans to serve children ages 0 months and 12 years old. The applicant rents the home and provided proof of control of property. This is a 3 bedroom, 2 bathroom one story home. All areas on the Facility Sketch LIC999 were inspected. Areas Designated for Day Care Activities: Living Room, Dining Room, Kitchen, Bedroom #3, and Bathroom #1, and a front yard (fenced) as the day care areas. Based on the Facility Sketch LIC999 submitted, areas off-limits to children are as follows: Bedroom #1, Bedroom #2, Bathroom #2, and the backyard (fenced), and garage as off-limits areas. There are child-proof locks or latches to make the off-limit areas inaccessible to children in care. There is a working telephone or cell phone service at the facility. There is enough ventilation, and heating. APPLICANT RENTS/LEASES THE HOME AND HAS LANDLORD CONSENT: Because the applicant, rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). LPA advised the applicant no changes should be made to the home without prior notice and/or approval from Licensing. The applicant states they are financially secure to operate a family childcare home for children and will comply with all regulations and laws governing family childcare homes.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SEMEXANT, JOHNSON FAMILY CHILD CARE	FACILITY NUMBER: 376629897
	VISIT DATE: 05/20/2024

NARRATIVE

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2. LPA Williams observed the detergents, cleaning compounds, medicines, sharp objects, and hazardous items were made inaccessible to children through latches, locks, and /or placed up on high surfaces. The applicant stated that there are no weapons or firearms in the house. There is a 2A-10BC fire extinguisher(s), and the smoke and carbon monoxide detectors meet requirements and are operable.

There are safe toys, play equipment, and materials for children. No smoking, No Johnny jumpers, no saucer chairs: any other items that fall into that category are prohibited in the facility. Outdoor play activities will be conducted in front yard.

The applicant stated he will provide food for the children. The applicant was informed if children bring food from home, the children’s names must be labeled on their lunch bags and refrigerated/stored properly. Per the applicant, children will nap in the bedroom #3 and living room. Children will nap on trundle bed/toddler bed/ cots/mats and infants in cribs/play yards. LPA discussed the safe sleep regulations with the 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.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SEMEXANT, JOHNSON FAMILY CHILD CARE	FACILITY NUMBER: 376629897
	VISIT DATE: 05/20/2024

NARRATIVE

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3.A records review indicates the applicant completed the required Health and Safety Training with Nutrition and Lead Poisoning components. The applicant has a current Pediatric First Aid and CPR certification that expires on 8/21/2025. A first aid kit is available at the facility. The applicant has submitted proof of immunizations. The applicant has completed the required mandated reporter training. Recertification is required every two years. In the absence of the applicant, a qualified adult must be present to supervise the children—a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR certification, Pertussis, Measles, TB clearance, and Influenza, Mandated Reporter and valid criminal record clearance that is associated with the licensed facility.

The applicant was reminded one year after being licensed an annual fee must be paid by the due date, or a late fee shall be assessed and/or the license may be terminated.

Reporting Requirements:

1. Changes should be reported to the Department as soon as they occur, such as construction, remodeling, telephone number changes, and/or moving out from your home.

2. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

The applicant was reminded each family childcare home must conduct fire drills and disaster drills at least once every six months. The licensee must document the date and time of each drill. This documentation must be kept at the facility for review by the Department. The applicant was reminded each facility shall reveal the license number in all advertisements, publications, or announcements made with the intent to attract clients.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SEMEXANT, JOHNSON FAMILY CHILD CARE	FACILITY NUMBER: 376629897
	VISIT DATE: 05/20/2024

NARRATIVE

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4.Criminal Record Clearance
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, 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.

APPLICANT KNOWS PROSPECTIVE CLIENTS WILL NEED IMS:
This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. 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) or (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.

APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS:
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) or (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 reviewed with the 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. Entrance Checklist was provided to the applicant.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: SEMEXANT, JOHNSON FAMILY CHILD CARE	FACILITY NUMBER: 376629897
	VISIT DATE: 05/20/2024

NARRATIVE

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5. On this date, 05/20/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. 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 platforms. 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. LPA discussed and provided Licensee with the following: childcare advocates email address: childcareadvocatesprogram@dss.ca.gov. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

The maximum capacity for a small family childcare home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or (with landlord consent) 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

The following corrections are needed prior to the issuance of the license:
1. There are three dogs during the inspection, but on 05/21/2024 two of the dogs will be removed from the home to create a future fire clearance area. Shadow the small white dog will be the only dog on premises.

2. Door Knob that is locked from outside for Garage.

3. Remove or Repair Trampoline.

4. Tie down white tarps in front yard to make fence holes inaccessible to young children.

5. Update and email Emergency and Disaster Form section 4 with new temporary relocation sites.

6. Area "off limits" in front yard left side of the home barricade/ make inaccessible to children in care.

An exit interview conducted, and report was reviewed with the applicant, Johnson Semexant. Once the proof is received by the licensing agency, a Small Family Child Care Home License for 8 may be issued upon a final file review.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2024

LIC809 (FAS) - (06/04)

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