<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500816
Report Date: 11/08/2023
Date Signed: 11/08/2023 03:10:33 PM

Document Has Been Signed on 11/08/2023 03:10 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:HILLMAN, JAKESHAFACILITY NUMBER:
394500816
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 7DATE:
11/08/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Licensee Jakesha HillmanTIME COMPLETED:
03:30 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
On 11/8/23, Licensing Program Analyst (LPA) Carla Polanco Rivera conducted a Case Management visit for the purpose of increasing the licensed capacity from 8 to 14 children. LPA met with Licensee Jakesha Hillman. Fire safety Inspection Clearance was granted on 8/30/23 for a total capacity of (14) children. Facility hours of operation are Monday through Friday, 7:00 AM to 5:30 PM. All individuals subject to criminal background review have obtained a criminal record clearance. At the time of the inspection there were seven children being supervised by Licensee.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas in the FCCH include all bedrooms, garage, laundry room and backyard. During today's visit Licensee requested for the bedroom at the left end of the hallway (bedroom #3) to be included in the FCCH, LPA verified safety of the new added room. As of today's visit updated Off-limits areas in the FCCH are Bedrooms 1,2 and 4, the garage, laundry room and backyard. LPA observed that hazardous items were inaccessible to children in care. LPA observed age-appropriate toys and napping equipment. Licensee stated there are no weapons in the home. No bodies of water were observed by LPA. Home has a working telephone, 2A10BC fire extinguisher and functioning smoke and carbon monoxide detectors. Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes. Licensee rents the home, Licensee provided the LIC 9151 Property owner/Landlord Notification.



Licensee's Mandated Reporter Training certificate expires 03/2025. Licensee’s CPR/First Aid certification was expired. Licensee signed up for her CPR re-certification course during the visit. Licensee states that she will follow up with LPA once course has been completed for her CPR/first aid re-certification.

Report continued on LIC809C............
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
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: HILLMAN, JAKESHA
FACILITY NUMBER: 394500816
VISIT DATE: 11/08/2023
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
26
27
28
29
30
31
32
Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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

LPAs 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. LPAs also informed 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, 11/8/23, Licensee is approved for a Large Family Child Care Home, with a maximum capacity of 14 children, one (1) of which must be enrolled in Kindergarten and at least one (1) 6 years of age and no more than three (3) may be infants; or 12 children, four (4) of which may be infants. Infants are children under the age of 2.

Licensee understands that when there is no assistant present, facility shall revert to that of a small family child care home.

An exit interview was conducted, and the report was reviewed with the licensee. A notice of site visit was provided and posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2