394500839-5-4-2023-53-CC-DNGN-CRHR2W-20230504123900

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500839
Report Date: 05/04/2023
Date Signed: 05/04/2023 12:39:09 PM

Document Has Been Signed on 05/04/2023 12:39 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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME:	MCCOY, CHARLA		FACILITY NUMBER:	394500839
ADMINISTRATOR:	MCCOY, CHARLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 200-3067
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95219
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS:	DATE:	05/04/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Charla McCoy		TIME COMPLETED:	12:45 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	On May 4th, 2023, at 9:30 AM, Licensing Program Analyst (LPA), David Nguyen met with Licensee, Charla McCoy, for the purpose of conducting a change-of-location inspection. LPA was granted for entry into the facility by licensee. Licensee's operating hours are Saturday through Saturday from 6:00 AM. to 6:00 PM. Meals—breakfast, AM snack, lunch, PM snack, and dinner—are provided to daycare children. Drinking water is provided with filtered water. All adults subject to criminal background review have obtained criminal record clearance. Licensee 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. A health and safety inspection was conducted in all areas accessible to children. The two-story home has 4 bedrooms and 2.5 bathrooms. Off-limits areas include the entire upstairs, laundry room, and attached garages. Off limit areas will remain inaccessible by door handle covers and baby gates. On-limits areas include the entire downstairs—playroom, living room, dining room, family room, kitchen, and backyard. LPA observed the required postings and a working phone. 2A10BC fire extinguisher meets regulations. The first aid kit is located in the kitchen. Smoke alarm and carbon monoxide detectors were observed and verified they were both functional. There is a fireplace in the home. The fireplace needs a protective screen installed. Report continues on 809-C.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MCCOY, CHARLA	FACILITY NUMBER: 394500839
	VISIT DATE: 05/04/2023

NARRATIVE

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LPA toured the kitchen area and verified knives were inaccessible to children in care. Hazardous items and personal hygiene items are made inaccessible to children. Sharp utensils are stored in locked drawers. LPA observed play area with age-developmental appropriate toys for children. LPA observed a restroom and verified that hazardous and toxic items were inaccessible to children in care. Licensee stated there are no weapons in the home. There are no bodies of water on the premises. Outdoor play space is fenced.

Licensee has a current valid Mandated Reporter Training Certificate and expires 2/13/2024 and Pediatric CPR and First Aid Training Certificate and expires 2/16/2025.

LPA discussed the safe sleep regulations with licensee and discussed 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 licensee 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. LPA discussed the requirement to check and log infant napping every 15 minutes, for infants under 24 months. LPA provided a copy of LIC 9227 Individual Sleeping Plan, for infants under 12 months.

Incidental Medical Services (IMS) policy was discussed with Licensee. For IMS information, see PIN 22-02-CCP. 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Report continues on 809-C.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

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 SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MCCOY, CHARLA	FACILITY NUMBER: 394500839
	VISIT DATE: 05/04/2023

NARRATIVE

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Licensee understands that anyone living or working in the home, eighteen years of age or older must obtain fingerprint clearance PRIOR to living or working in the home. Licensee understands that licenses are not transferable, and once licensed, licensee must live in the home and be present for 80% of the operating hours.

Licensee understands that if an unusual incident occurs; licensing is to be notified via phone call, e-mail or fax within 24 hours and the Unusual Incident Report LIC 624 shall be submitted within 7 days to remain in compliance. Licensee understands that if any structural changes are made to the home; licensing must be notified prior to construction.

Licensee understands that if they want to make any OFF-limit area an ON-limits area, they must notify licensing and LPA must do an inspection BEFORE children are allowed in the area. Licensee understands that children’s records are to be maintained according to Title 22 regulations and be accessible to licensing for up to three years.

This facility evaluation report was reviewed and discussed with the licensee, Charla McCoy. LPA discussed licensing requirements with Licensee including the posting of licensing inspection notices and reports, as well as injury and incident reporting. LIC311D was provided and discussed. Licensee was encouraged to visit the department website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to family child care homes.

Effective today 5/4/2023, facility is approved for a Provisional Large Family Child Care License to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or above and 1 child at least age 6 with a maximum of 3 infants. Without assistant, the ratios revert to those for small family childcare home.

LPA will grant regular licensure after the following item is submitted or corrected:

1.A protective screen is obtained and installed for the fireplace in the family room.

A copy of the report is provided to Licensee.

SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023

LIC809 (FAS) - (06/04)

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