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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380506144
Report Date: 12/23/2022
Date Signed: 12/23/2022 11:31:33 AM

Document Has Been Signed on 12/23/2022 11:31 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:JENKINS, CAROLFACILITY NUMBER:
380506144
ADMINISTRATOR:JENKINS, CAROL A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 554-0559
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94117
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
12/23/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Carol JenkinsTIME COMPLETED:
12:00 PM
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On December 23, 2022 at 09:30AM, Licensing Program Analyst (LPA) Nathan Garcia arrived at the facility to conduct an unannounced Annual Inspection and met with the Licensee, Carol Jenkins. Purpose of the inspection was explained. There were no children present at the time of arrival. Per Licensee, the children enrolled are all out on vacation for the Christmas holidays, since yesterday (12/22/2022). LPA verified the background check clearance of the adults working or living in the home. The hours of operation are Monday through Friday, 08:00 AM 6:00 PM. License to provide AM/PM snacks, and lunches which will all be prepped and served at the facility. According to Licensee, the parents are given a choice to bring own food for their children as long as it's nut free. The food are properly labeled and refrigerated. Since Licensee haven't had an inspection for 5 years, LPA reviewed important information regarding the drills, infant safe sleep, logging and files for the children with Licensee.

Daycare areas: Downstairs Living room and half bathroom.
Off Limit areas: The entire upstairs bedrooms and bathrooms.
LPA observed that off limit areas were properly barricaded and made inaccessible to the children in care.

LPA and Licensee inspected the entire childcare area for Health and Safety hazards. There are carbon monoxide and smoke detectors in the home. LPA performed the tests to check the functionality of the detector. One fully charged fire extinguisher of size 2A10BC was also available in the home, located in the play area. First Aid kit is fully stocked and accessible. Licensee states, there are no bodies of water or weapons or guns in the home. Per Licensee, she has a pet dog in the home that only stays upstairs.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2022
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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: JENKINS, CAROL
FACILITY NUMBER: 380506144
VISIT DATE: 12/23/2022
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LPA observed that the house is in good repair and free of hazards with proper temperature and ventilation and lighting. The play area is carpeted and in good condition. LPA observed that there are a variety of age-appropriate toys, books, and other learning materials available in the home. There is a table for table-top activities such as crafts and for eating. Electric outlets have proper covers and a working phone is on site. The Licensee does not have liability insurance available LIC 282 is available and signed by parents.



All posting requirements are met and posted near the childcare entrance. Licensee has current and valid CPR and First Aid card expiring on 12/172024. Licensee also has mandated reporter certificate expiring on 12/18/2024. LPA reviewed facility records for the 5 children enrolled, regardless of having no helpers or children on this day. The facility conducts fire and earthquake drills every month with the children. The most recent one was on 12/8/22.

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.

Per Licensee, there no children with allergies currently enrolled. 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: www.ada.gov/childqanda.htm.



The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: JENKINS, CAROL
FACILITY NUMBER: 380506144
VISIT DATE: 12/23/2022
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LPA reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.

LPA encouraged the Licensee to visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

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.


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 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.

A copy of this report was given to the Licensee and a site visit notification must be posted for 30 days.



Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee, Carol Jenkins.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 12/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2022
LIC809 (FAS) - (06/04)
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