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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393616676
Report Date: 03/22/2023
Date Signed: 03/22/2023 02:02:40 PM

Document Has Been Signed on 03/22/2023 02:02 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:KELLY, SHARONFACILITY NUMBER:
393616676
ADMINISTRATOR:KELLY, SHARONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 943-5904
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY: 14TOTAL ENROLLED CHILDREN: 5CENSUS: 1DATE:
03/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Sharon KellyTIME COMPLETED:
02:15 PM
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On March 22, 2023, Licensing Program Analyst (LPA) Elvira Sierra met with the licensee, Sharon Kelly for the purpose of an annual inspection. Per licensee her new hours of operation are M-F from 06:00am to 12:00 am. A review of the Facility Personnel Summary shows that all adults living and working in the home have criminal record clearances on file with Licensing Office. Licensee stated that no new residents moved into the home since licensure. Capacity specified on the license was met on today’s inspection. During the inspection one daycare child arrived.

A health and safety inspection was conducted in all areas accessible to children. Off limit areas are: Entire upstairs, living room, laundry room, garage and the left side of the backyard. Licensee was reminded that day care children may never enter these off-limit areas. Licensee was also advised to contact Licensing office of any changes to the home previously identified as off limit to an area where care and supervision will be provided and if new construction is done to the home. Upon entry, LPA observed the posting of the facility license, Emergency Disaster Plan, Earthquake Preparedness Checklist and Notification of Parent Rights. Home is clean and appropriately ventilated. Age-appropriate toys and reading material were observed. There were no hazardous materials or chemicals accessible to children. Medications are inaccessible to children and kept in the kitchen on a top cabinet. The fireplace in the home is appropriately barricaded to prevent access by children. LPA observed that the stairs leading to the second floor was not barricaded. Licensee stated that she has only one child under the age of five and she always block the stairs when the child is present with a retractable baby gate. Licensee placed the gate during the inspection because child under the age of five arrived during the inspection. LPA reminded Licensee to always make sure stair are always block when a child under five years old is present. Licensee stated there are no weapons in the home. No bodies of water were observed on the premises. Facility maintains a working phone, 2A10BC fire extinguisher, and functioning smoke/carbon monoxide detector. Backyard is fenced for supervision.
Report continues on subsequent page 809C--
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2023
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: KELLY, SHARON
FACILITY NUMBER: 393616676
VISIT DATE: 03/22/2023
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Current in person EMSA CPR and First Aid certification was verified and expires on 03/07/24 and AB 1207 Mandated Reporter Training was verified and expires on 04/14/24. LPA observed a current roster and fire drills are conducted at least once every six months and are properly log. Last fire drill was conducted on 12/06/22.

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.

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 the safe sleep regulations 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.

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
This report and Appeal of Rights were provided and reviewed. Exit interview conducted and Notice of site Visit was posted.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
LIC809 (FAS) - (06/04)
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