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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500808
Report Date: 03/07/2024
Date Signed: 03/07/2024 10:34:55 AM

Document Has Been Signed on 03/07/2024 10:34 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:PRINGLE, TYIESHAFACILITY NUMBER:
394500808
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 9CENSUS: 3DATE:
03/07/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Tyesha PringleTIME COMPLETED:
10:50 AM
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On 03/07/24, 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, Tyesha Pringle. Fire safety inspection clearance was granted on 02/28/24 for a total capacity of 14 children. Facility hours of operation are seven days a week 24 hours a day. All individuals subject to criminal background review have obtained a criminal record clearance.
A health and safety inspection of all areas accessible to children was conducted and the following was observed. Off limits areas are: All bedrooms including bathroom # 2 inside master bedroom, Kitchen, Garage, and backyard. Licensee requested to make backyard off limits temporarily and will be using the front yard for outdoor activities. Licensee acknowledged that children may never enter these off-limit areas. Current CPR/First Aid certificates (expires: 05/29/24), posted License, Parent's Rights, Emergency Disaster Plan, Roster of the enrolled children, and Fire Drill Log are all being maintained by the Licensee. Hazardous items were stored inaccessible to children in care. A functioning telephone, fire extinguisher (2A10BC), carbon monoxide and smoke detector were observed. Toys appear to be safe and age appropriate. Fireplace in the living room is barricaded. Licensee was advised that 100% supervision is required on unfenced areas. There are no bodies of water on the premises. The licensee was advised that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.
Capacity increase is approved as of today, March 07, 2024. The facility is licensed to serve a MAX. CAP(WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.
In the areas that were evaluated, no deficiencies were observed at the time of the visit. During the exit interview, the LICENSEE, Tyesha Pringle, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
Notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee, Tyesha Pringle.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 03/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/07/2024
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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