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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393619750
Report Date: 12/01/2022
Date Signed: 12/01/2022 02:57:18 PM

Document Has Been Signed on 12/01/2022 02:57 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:STOVALL, ANTHONYFACILITY NUMBER:
393619750
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 13CENSUS: 1DATE:
12/01/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Anthony StovallTIME COMPLETED:
03:30 PM
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On 12/01/22, Licensing Program Analysts (LPAs) Elvira Sierra and Corina Beckby conducted a Case Management visit for the purpose of increasing the licensed capacity from 8 to 14 children. LPAs met with Licensee, Anthony Stovall . Fire safety Inspection Clearance was granted on 11/21/22 for a total capacity of 14 children. Facility hours of operation are seven days a week 24 hours a day. Licensee was advised not to exceed 24 hours of consecutive care. All individuals subject to criminal background review have obtained a criminal record clearance. LPAs observed Licensee caring for one child.

A health and safety inspection was conducted in all areas accessible to children. Home appears orderly and suitable for children. Off-limits areas include; Living room, dining room, son’s bedroom, master bedroom (including bathroom inside master bedroom), laundry room, garage, and backyard.


Hazardous items were stored inaccessible to children. Napping equipment and age appropriate toys were observed. Licensee stated there are no weapons in the home. No bodies of water were observed. Home has a working telephone, 2A10BC fire extinguisher and a functioning smoke and carbon monoxide detectors. Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes. Licensee rents the home. Licensee provided a LIC 9151 (Property owner/Landlord Notification). Licensee current CPR/First Aid was verified (2/27/24). Mandated Reporter Training expires on 10/18/24. Licensee stated that he will transport children. Licensee acknowledges that only drivers licensed for the type of vehicle to be operated shall be permitted to transport children in care, the manufacturer's rated seating capacity of the vehicle shall not be exceeded, motor vehicles used to transport children in care shall be maintained in safe operating condition, and all vehicle occupants must be secured in an appropriate restraint system. Licensee stated he provide meals to children and he is enrolled with the Child Care Food Program. During the inspection LPAs reviewed large family childcare home capacity limitations with licensee and a capacity roster was provided to Licensee.

Report continues on subsequent page 809C---
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: STOVALL, ANTHONY
FACILITY NUMBER: 393619750
VISIT DATE: 12/01/2022
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Licensee, 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.

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

LPAs 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. LPAs also informed 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

Capacity increase is approved as of Today, 12/01/22. The facility is licensed to serve a MAX. CAP(WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. Licensee understands that if he provides Landlord Consent to Licensing he can increase capacity to 14 children. ( CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6).

Notice of Site Visit was provided and posted. Notice of Site Visit must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the Licensee, Anthony Stovall.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2022
LIC809 (FAS) - (06/04)
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