394500808-3-19-2024-53-CC-ESIA-CP3T8F-20230215133017

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500808
Report Date: 02/15/2023
Date Signed: 03/19/2024 09:26:57 AM

Document Has Been Signed on 03/19/2024 09:26 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:	PRINGLE, TYIESHA		FACILITY NUMBER:	394500808
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	02/15/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Tyesha Pringle		TIME COMPLETED:	01:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	This is an amended version of a report originally signed on 02/15/23. On Wednesday, February 15, 2023, Licensing Program Analyst (LPA) Elvira Sierra met with Applicant, Tyesha Pringle for the purpose of a change of location. Previously, the applicant was licensed (394500236) at different location and has recently moved at this location.Home is a single story 2 bedrooms 2 bathrooms duplex. Facility hours of operation will be seven days a week 24 hours a day. Applicant was advised never to exceed 24 hours of consecutive care. All individuals subject to criminal background review have obtained a criminal record clearance. Applicant understands that any children under age 10 living in the home will enter the daycare capacity. A health and safety inspection was conducted in all areas of the home. Home is clean and suitable for children. Off-limits areas include; All bedrooms including bathroom # 2 inside master bedroom, Kitchen, Garage, and Front yard. Parent's Rights, current Emergency Disaster plan and COVID-19 posting was observed to be posted. Hazardous items were stored inaccessible to children. Napping equipment and age appropriate toys were observed. Applicant stated there are no weapons in the home and no bodies of water were observed. Home as a working telephone, 2A10BC fire extinguisher and a functioning dual smoke and carbon monoxide detectors. The backyard is fenced for supervision. Facility will provide meals. Applicant rents the home and provided a copy of the lease agreement. Landlord consent was obtained. Applicant understands that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed changes. Applicant current CPR/First Aid was verified (05/29/24). LIC 311D (Forms/Records to keep in your Family Child Care Home) were reviewed and updated forms were provided to applicant. Report continues on subsequent page 809C----

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

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: PRINGLE, TYIESHA	FACILITY NUMBER: 394500808
	VISIT DATE: 02/15/2023

NARRATIVE

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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 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 [facility representative] 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/inspection-process.

Effective today (02/15/23) the facility is LICENSED to serve a MAX. CAP: 6 - NO MORE THAN 3 INFANTS OR 4 INFANTS ONLY. CAP 8 - NO MORE THAN 2 INFANTS, 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

Exit interview conducted, this report and Appeal of Rights were reviewed and provided to Applicant, Tyesha Pringle.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

LIC809 (FAS) - (06/04)

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