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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621483
Report Date: 10/16/2023
Date Signed: 10/16/2023 05:03:53 PM

Document Has Been Signed on 10/16/2023 05:03 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:HANIFIN, DESTINYFACILITY NUMBER:
393621483
ADMINISTRATOR:DESTINY HANIFINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 275-5778
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
10/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Destiny HanifinTIME COMPLETED:
05:15 PM
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On 10/16/2023 at 1:45 PM, Licensing Program Analyst (LPA) Tiffanie Diep met with Licensee Destiny Hanifin for the purpose of an unannounced annual inspection, and Licensee guided LPA on a tour of the home. LPA observed five children present in the home with Licensee and their assistant. Licensee's operating hours are Monday through Sunday from 6:00 AM to 6:00 PM. LPA verified that annual fees are current.

All individuals subject to a criminal record review have obtained a criminal record clearance. Licensee was reminded that all adults 18 and over living or working in the home, 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 five 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.

LPA reviewed five children's files, and LPA observed emergency information and required immunization records were on file. LPA observed a current roster. LPA discussed the requirement to conduct and document fire and disaster drills at least once every six months. LPA verified Licensee's immunization records were available in the facility file. LPA reminded Licensee to maintain documentation of the required immunizations for all employees and volunteers. Mandated Reporter Training certificate expired on 02/26/2022. LPA discussed the mandated reporter training requirement and informed Licensee that certifications are to be AB1207 compliant. Licensee was reminded to renew the course every two years. Current EMSA pediatric CPR and first aid certification was verified and expires on 02/18/2025.

Continues on 809-C
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2023
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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: HANIFIN, DESTINY
FACILITY NUMBER: 393621483
VISIT DATE: 10/16/2023
NARRATIVE
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Continued from 809 (Page 2)

A health and safety inspection of the home’s interior and exterior was conducted in all areas accessible to children. LPA observed the required postings and a working phone. LPA observed a 3A40BC fire extinguisher meets regulations and verified both smoke and carbon monoxide detectors were functional. LPA toured the kitchen area and verified knives were inaccessible to children in care. LPA observed a restroom and verified that toxic and hazardous items were inaccessible to children in care. LPA observed cleaners stored underneath the kitchen sink and inaccessible to children in care. LPA observed the formal front room and formal dining area with age-appropriate toys for children. Licensee stated there are no weapons in the home. LPA observed a fireplace that was barricaded by a glass screen. Licensee stated they do not use the fireplace during day care hours and will maintain supervision to ensure children's safety. Per Licensee’s request, the off-limits areas in the home will now include all bedrooms and the garage. The outdoor play area was inspected and is surrounded by a wooden fence. LPA walked the perimeter of the outdoor play area during inspection and verified that the entire area is fenced in. LPA did not observe bodies of water on the premises.

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. LPA discussed the requirement to check and log infant napping every 15 minutes for infants under 24 months. LPA provided a copy of the Individual Sleeping Plan (LIC 9227) for infants under 12 months.

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 https://www.ada.gov/resources/child-care-centers/.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023
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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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: HANIFIN, DESTINY
FACILITY NUMBER: 393621483
VISIT DATE: 10/16/2023
NARRATIVE
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Continued from 809-C (Page 3)

To improve the quality and value of the new inspection process, a survey may be sent to the e-mail address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE Tool, please send e-mail inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at https://www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process. Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Because Licensee rents/leases the home, proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification form (LIC 9151) that Licensee confirms was provided to the property owner/landlord. Licensee obtained a signed Property Owner/Landlord Consent Form (LIC 9149).

Based on LPA’s observations, interviews conducted, and records reviewed, deficiencies are being cited on the attached LIC 809-D. LPA Tiffanie Diep informed the licensee, Destiny Hanifin, that this report dated 10/16/2023 documents three Type B citations as there were potential risks to the health, safety, or personal rights of children in care.

An exit interview was conducted and report was reviewed with the licensee, Destiny Hanifin. During the exit interview, Licensee confirmed that there are no registered sex offenders (RSO) living in the facility and LPA completed the RSO profile in the Field Automation System. A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2023
LIC809 (FAS) - (06/04)
Page: 3 of 5
Document Has Been Signed on 10/16/2023 05:03 PM - It Cannot Be Edited


Created By: Tiffanie Diep On 10/16/2023 at 04:07 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: HANIFIN, DESTINY
FACILITY NUMBER: 393621483

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interviews conducted, and records reviewed, the licensee did not comply with the section cited above as LPA observed the last fire and disaster drill was conducted on 03/10/2023 which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 11/16/2023
Plan of Correction
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Licensee agreed to provide documentation of completed drill to LPA by 11/16/2023
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interviews conducted, and records reviewed, the licensee did not comply with the section cited above as licensee did not ensure correct mandated reporter trainings were completed by the expiration dates which poses a potential health, safety, or personal rights risk to children in care.
POC Due Date: 11/16/2023
Plan of Correction
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Licensee agreed to provide completed certificates for themselves and their assistant to LPA by 11/16/2023
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Chayntel Hunter
LICENSING EVALUATOR NAME:Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2023


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Document Has Been Signed on 10/16/2023 05:03 PM - It Cannot Be Edited


Created By: Tiffanie Diep On 10/16/2023 at 04:07 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: HANIFIN, DESTINY
FACILITY NUMBER: 393621483

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observations, interviews conducted, and records reviewed, the licensee did not comply with the section cited above as licensee did not ensure required immunizations were maintained for all personnel which poses a potential health, safety, or personal rights risk to children in care.
POC Due Date: 11/16/2023
Plan of Correction
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Licensee agreed to provide proof of required immunizations for their assistant to LPA by 11/16/2023
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Chayntel Hunter
LICENSING EVALUATOR NAME:Tiffanie Diep
LICENSING EVALUATOR SIGNATURE:
DATE: 10/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/16/2023


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