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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500515
Report Date: 11/23/2021
Date Signed: 11/23/2021 10:16:17 AM

Document Has Been Signed on 11/23/2021 10:16 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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:HILL, DENISHAFACILITY NUMBER:
394500515
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
11/23/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Denisha HillTIME COMPLETED:
10:35 AM
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On Thursday, November 23, 2021 at 09:15 am, Licensing Program Analyst (LPA) Elvira Sierra met with applicant, Denisha Hill for the purpose of an announced pre-licensing inspection. Home is a one story 3 bedroom and 2 bathrooms house. Applicant acknowledges that any children under the age of 10 years living in the home are to be included in license's capacity when present. Facility hours of operation will be 7 days a week 24 hours a day. Applicant understands not to exceed 24 hours of consecutive care. All individuals subject to criminal background review have obtained a criminal record clearance.

LPA toured the facility and a health and safety inspection was conducted inside and out. The off-limit areas in the home consist of; Bedroom # 1 and # 2, bathroom # 2 (inside master bedroom), Garage and backyard. Applicant understands that children may never enter these off-limits areas. Applicant acknowledges that she is required to notify licensing prior to making changes to off-limit areas. The facility appeared orderly and suitable for children. LPA observed variety of toys and learning equipment. Toxic and hazardous items are inaccessible to children. Applicant acknowledges poisons are to be locked under lock and key or combination lock while day care children are present. Safety latches are in use on some kitchen cabinets and bathroom cabinets and drawers. The applicant understands that she must ensure the safety latches are not broken. A working telephone, 2A10BC fire extinguisher and functioning smoke and carbon monoxide detectors were observed at the home. There are no bodies of water on the premises. Per License there are no weapons in the home. Applicant understands children must have on-site supervision in unfenced areas and during water activities.
Applicant stated that she will be transporting children and she understands the seat belt laws. Applicant owns the home and provided LPA with a copy of the grant deed to confirm control of property. LPA explained about obtaining $300,000 liability insurance. Applicant understands that until a policy is obtained, an affidavit must be used.
Report continues on subsequent page 809C---
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/23/2021
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: HILL, DENISHA
FACILITY NUMBER: 394500515
VISIT DATE: 11/23/2021
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The Applicant completed the preventative health and safety training which includes the nutrition training. The Applicant has completed the Pediatric CPR and First Aid training and expires on 09/17/2023. The Applicant provided proof of Immunization's to meet SB792 and completed the mandatory child abuse training and LPA explained that training must be completed every two years (AB1207). Mandated Reporter Training expires on 08/2023. LPA discussed the smoking prohibition with the Applicant. Type A/B citations and Immediate Civil Penalty regulation deficiencies were reviewed. LPA also explained the Zero Tolerance and immediate Civil Penalty regulation deficiencies and citations.
Applicant 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 the Child Care Licensing Safe Sleep webpage athttps://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.
Effective today, November 23 2021, LPA is granting a license to serve up to either 8 children, two (2) of which must be at least 6 years of age and no more than two (2) may be infants; or 6 children, three (3) of which may be infants; or 4 infants only. Infants are children under the age of 2 years.
Exit interview conducted and report was reviewed with the Applicant.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 11/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/23/2021
LIC809 (FAS) - (06/04)
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