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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394501211
Report Date: 09/19/2024
Date Signed: 09/19/2024 12:22:00 PM

Document Has Been Signed on 09/19/2024 12:22 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:PETRY, QUIANA & WHITT, JENAHAFACILITY NUMBER:
394501211
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
09/19/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Quiana Petry & Jehana WhittTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On 09/19/24, Licensing Program Analyst (LPA) Elvira Sierra met with Applicants, Petry Quiana and Jehana Whitt for the purpose of an announced pre-licensing inspection. All individuals subject to criminal background review have obtained a criminal record clearance. Home is a single story duplex three bedrooms and two bathroom house. Applicants stated facility hours of operation will be seven days a week 24 hours a day. Applicants were advised never to exceed 24 hours of consecutive care.
A health and safety inspection was conducted in all areas of the home. Off-limits areas will include; Master bedrrom including bathroom inside the master bedroom, backyard, front yard, driveway and garage. Off-limits areas will remain inaccessible to children by closed doors, locks and/or supervision. Applicants acknowledged that children may never enter these off-limit areas. Applicants understands that if any structural changes are made to the home, Licensing must be notified prior to construction. Applicants also understands that Licensing must be notified prior to use of any off-limits area and an inspection must be completed by an LPA before children are allowed in the area. Home is cleaned and suitable for children. Age-appropriate toys and reading material were observed. Sufficient napping equipment was observed for the request capacity. LPA verified all medication/knives, toxic and hazardous items were stored inaccessible to children. A 2A:10BC fire extinguisher and smoke/carbon monoxide detectors were observed. Applicants stated there are no weapons in the home and no bodies of water were observed. A nearby park will be used for outdoor activities until the backyard is ready to use. Applicants were advised that 100% supervision is required on unfenced areas. Applicants stated that facility will provide meals and planning to enroll with the Food Program.
Applicants stated that facility will provide transportation for clients. At this time, the facility does not carry childcare liability insurance. LPA explained about obtaining a $300,000 annual aggregate/$100,000 per occurrence liability insurance policy. Applicants understand that until a policy is obtained, they must use the affidavit.
Report continues on subsequent page 809C---
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2024
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 3
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: PETRY, QUIANA & WHITT, JENAHA
FACILITY NUMBER: 394501211
VISIT DATE: 09/19/2024
NARRATIVE
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Applicant rents the home and provided a copy of the lease agreement to LPA on today's visit. LPA reviewed the fire drill requirements. Applicants have certificates of completion for Preventative Health and Safety training; CPR/First Aid for applicants expired on 06/2026. Mandated Reporter Training (expires: 08/15/2026) Postings are posted by the main entrance of the home. Applicants are reminded of NO walker, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible.

LPA reviewed the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Applicants were explained that absences shall not exceed 20 percent of the hours that the facility is providing care per day. The department must be notify anytime facility is closing for vacation or any other leave that requires to be absence more than 20 percent per day.

Applicants were 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.
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 applicants 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.
Incidental Medical Services (IMS) policy was discussed. 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: https://www.ada.gov/resources/child-care-centers/

Report continues on subsequent page 809C---
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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: PETRY, QUIANA & WHITT, JENAHA
FACILITY NUMBER: 394501211
VISIT DATE: 09/19/2024
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LPA discussed the smoking prohibition with the applicant. Type A/B citations and Immediate Civil Penalty regulation deficiencies were reviewed. LPA also explained the Zero Tolerance and immediate Civil Penalty regulation deficiencies and citations.
Applicants were informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
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.
During the exit interview, the Aplicants, Quiana Petry and Jehana Whitt confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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 atwww.cdss.ca.gov/inforesources/community-care-licensing/process.

Effective today (09/19/24), the facility is licensed to serve a MAX. CAP: 6 - NO MORE THAN 3 INFANTS OR 4 INFANTS ONLY. or CAP 8 - NO MORE THAN 2 INFANTS, 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.
Exit interview conducted and report was reviewed with the Applicants, Quiana Petry and Jehana Whitt.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC809 (FAS) - (06/04)
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