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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500684
Report Date: 03/06/2025
Date Signed: 03/06/2025 03:49:47 PM

Document Has Been Signed on 03/06/2025 03:49 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:MADDOX, HOWARD & KARLAFACILITY NUMBER:
394500684
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
03/06/2025
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:11 PM
MET WITH:Dulce Leal and Luz MartinezTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On 03/06/25, Licensing Program Analyst (LPA) Elvira Sierra conducted a Case Management visit for the purpose of increasing capacity from 8 to 14 children and met with Licensee's Assistants, Dulce Leal and Luz martinez. Fire Safety Inspection Clearance was granted on 03/05/25 for a total capacity of 14 children. Facility hours of operation are M-F from 06:00am to 06:00pm year-round with periodic break throughout the year. Upon arrival present in the facility were 2 Licensee's assistants caring for 5 daycare children.

A health and safety inspection of all areas accessible to children was conducted and the following was observed. Home was observed clean and orderly. Off limits areas are: Entire home except day care area, TV room, bathroom #2, office space by the daycare room and right/left side of the backyard. Licensee acknowledged that children may never enter these off-limit areas. Licensees CPR/First Aid certificates (expires: 01/27), posted License, Parent's Rights. Licensee, Howard Maddox stated over the phone that there are no weapons in the home. A functioning telephone, fire extinguisher (2A10BC), carbon monoxide and smoke detector were observed. Toys appear to be safe and age appropriate. The backyard is fenced for supervision. Facility has a hot tub located in the backyard. Hot tub cover was not locked and LPA observed water inside the hot tub. There is a storage shed in the backyard. Storage shed was not locked and hazardous items were observed.

LPA spoke to Licensee, Howard Maddox over the phone and explained that absences shall not exceed 20 percent of the hours that the facility is providing care per day. Licensees must notify the department anytime facility is closing for vacation or any other leave that requires to be absence more than 20 percent per day.


Report continues on subsequent page 809C--
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: MADDOX, HOWARD & KARLA
FACILITY NUMBER: 394500684
VISIT DATE: 03/06/2025
NARRATIVE
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Increase of Licensee capacity will be granted upon the following corrections:

-Storage shed and Hot tub located in the backyard must be locked.

LPA Sierra informed facility representatives that this report dated 03/06/25 documents (two Type A citation) Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Sierra informed the facility representatives to provide a copy of this licensing report dated 03/06/25 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224 ), or other written statement, must be placed in the child's file for verification.

Deficiencies cited on page 809D. Notice of site visit was posted and must remain posted for 30 days. Exit interview conducted. Appeal of Rights and report was reviewed and provided to facility representatives, Luz Martinez and Dulce Leal.

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

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 03/06/2025 03:49 PM - It Cannot Be Edited


Created By: Elvira Sierra On 03/06/2025 at 02:18 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: MADDOX, HOWARD & KARLA
FACILITY NUMBER: 394500684

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/07/2025
Section Cited
CCR
102370(d)(1)

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102370(d)(1)Criminal Record Clearance d)All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:
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LPA spoke to Licensee, Howard Maddox over the phone and he stated that Adult#1 will submit fingerprint clearance by the due date and will submit proof to LPA.
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(1) Obtain a California clearance or a criminal record exemption as required by the Department . This requirement was not met as evidence by; Adult #1 did not obtained fingerprint clearance prior to be working at the facility. This is a requirement that if not corrected poses an immediate risk to the health and safety to the children in care.
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A $100 immediate civil penalty was issued during the visit.
Type A
03/07/2025
Section Cited
CCR102417(g)(5)

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102417 Operation of a Family Child Care Home g) The home shall be free from defects or conditions which might endanger a child..... :(5) All licensees shall ensure the inaccessibility of.....(in-ground and above-ground), fixed-in-place .
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Licensee, Howard Maddox stated over the phone that he will fix the hot tub cover locks.
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wading pools, hot tubs, spas, fish ponds and similar...This requirement was not met as evidence by: Hot tub cover was not locked and LPA observed water inside the hot tub. This is a requirement that if not corrected poses an immediate risk to the children in care.
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Licensees will correct deficiency by the due date. A secon inspection will be required to verify corrections.
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:Bettina Engelman
LICENSING EVALUATOR NAME:Elvira Sierra
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/06/2025 03:49 PM - It Cannot Be Edited


Created By: Elvira Sierra On 03/06/2025 at 02:52 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: MADDOX, HOWARD & KARLA
FACILITY NUMBER: 394500684

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/07/2025
Section Cited
CCR
102417(g)(4)

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102417 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 be limited to:4) Poisons, detergents, cleaning compounds........
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Licensee, Howard Maddox stated over the phone that he will have that deficiency corrected by the due date making sure storage shed is always lock.
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which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement was not met as evidence by: LPA observed the storage shed in the backyard unlocked with hazardous items. This is a deficiency that if not corrected can pose a risk to the health and safety of the children in care.
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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:Bettina Engelman
LICENSING EVALUATOR NAME:Elvira Sierra
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2025


LIC809 (FAS) - (06/04)
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