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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394501238
Report Date: 09/26/2024
Date Signed: 09/26/2024 12:39:02 PM

Document Has Been Signed on 09/26/2024 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:STOVALL, CARLAFACILITY NUMBER:
394501238
ADMINISTRATOR/
DIRECTOR:		STOVAL, CARLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 808-6182
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/26/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Carla StovallTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On 09/26/24, Licensing Program Analyst (LPA) Elvira Sierra met with Licensee, Carla Stovall for the purpose of conducting a change of location inspection. Licensee is requesting a change of location from previous facility (# 393617658) to current location. Licensee’s tentative operating hours are Monday through Friday 24 hours a day. Licensee was advised never to exceed 24 hours of consecutive care. Present during the inspection was Licensee and her sister (Licensee's assistant).

The facility is a two story home that consists of 5 bedrooms, and 3 full bathrooms. LPA toured the entire home inside and outside. Off limit areas are; Entire home except bedroom #1, bathroom #1, family room and front yard. Licensee acknowledged that children are never allowed in the off-limit areas. Off limit areas will remain inaccessible to children by closed/ locked doors and supervision. 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. Backyard is completely fenced and is off limits to the children. Licensee stated there are no weapons in the home. There is an in ground swimming pool located in the backyard. Licensee was advised that swimming pool fence must enclosed the entire pool. LPA provided body of water evaluation documentation to Licensee as a guide to follow in the fencing requirements. Front yard will be used for outdoor activities and is fenced for supervision.

Fire extinguisher and first aid kit is located in the kitchen and one more fire extinguisher is located by bedroom #1. Smoke alarm and carbon monoxide detectors were observed. Hazardous items and personal hygiene items are made inaccessible to children. Licensee has a current Mandated Reporter Training Certificate that expires 01/2026 ent pediatric CPR and first aid training was verified and expires on 01/2026.Facility provide meals and transportation if needed for clients. Report continues on subsequent page 809C-
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/26/2024
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: STOVALL, CARLA
FACILITY NUMBER: 394501238
VISIT DATE: 09/26/2024
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LPA discussed IMS services and the requirement to create a plan of operation. 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.
The license explained that absences shall not exceed 20 percent of the hours that the facility is providing care per day. Licensee must notify the department anytime facility is closing for vacation or any other leave that requires to be absence more than 20 percent per day.
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.

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 children’s records are to be maintained according to Title 22 regulations and be accessible to licensing for up to three years.


The licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.Exit interview conducted and this facility evaluation report was reviewed and discussed Licensee, Carla Stovall. Records, postings, and reporting requirements were discussed. 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.

Applicant owns the home. The applicant will provided proof of control of property to LPA. LPA reviewed the $300,000 Liability Insurance OR Applicant will have the parents sign the Affidavit of the Liability Insurance.


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

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC809 (FAS) - (06/04)
Page: 2 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: STOVALL, CARLA
FACILITY NUMBER: 394501238
VISIT DATE: 09/26/2024
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During the exit interview, the LICENSEE, Carla Stovall, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
Licensee will be approved upon the following:
-Licensee will install a fence that surround the swimming pool completely so no windows/doors lead to the swimming pool.

Exit interview conducted and this report and Appeal of Righs were reviewed and provided to Licensee, Carla Stovall.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2024
LIC809 (FAS) - (06/04)
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