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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410507023
Report Date: 04/06/2022
Date Signed: 04/06/2022 12:14:18 PM

Document Has Been Signed on 04/06/2022 12:14 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BOYD, SHERRI A.FACILITY NUMBER:
410507023
ADMINISTRATOR:BOYD, SHERRI A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 347-1934
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 4DATE:
04/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Sherri BoydTIME COMPLETED:
12:30 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 April 6, 2022, Licensing Program Analysts (LPA), Van conducted an unannounced required annual inspection and met with the Licensee, Sherri Boyd. The purpose of the inspection was explained and granted entry to the home by the Licensee. The home is a single-family house. There are four children in care with Licensee (3 infants and 1 preschooler.) All adults living or working in the home have a criminal background clearance on file. Daycare Areas are the living/dining room, kitchen, hallway bathroom, bedroom (next to the kitchen), two bedrooms (napping only), and backyard. During the inspection, the Licensee requested to make the bathroom (next to the kitchen) previously be an off-limit to the daycare area. LPA inspected the bathroom and approved it as a daycare today. The new Off-limits Areas now is just the Garage. The Days and operation hours are 7:30 am – 5:30 pm, Monday – Friday. All off-limit areas are adequately barricaded. The Licensee states that if the children showed signs of illness, she will separate them and have them stay in one of the napping rooms while contacting the parents to pick them up.
LPA and Licensee inspected the daycare areas for health and safety hazards during the inspection. The daycare area is clean, orderly, and equipped with safe, age-appropriate toys and equipment. The home has adequate heating, lighting, and ventilation and is free from defects or conditions that endanger children in care. The fireplace was observed to be screened off, and toys chest were placed in front. The home has a smoke alarm & carbon monoxide detector and fully charged fire extinguishers. All unused electrical outlets have a child-proof cover. The bathroom sink cabinet stores poisons, detergents, and cleaning compounds. The cabinet has child-proof latches installed. Per Licensee, there are firearms in the home, the weapons are inaccessible to children and are locked, and ammunition is locked separately. The Licensee states she has two dogs. Both dogs had up-to-date vaccinations. LPA observed no pools; however, there is a hot tub in the backyard; the hot tub is inaccessible to children and has a hardtop cover. LPA observed the Licensee had posted all the required forms, such as facility License, Notification of Parent's Rights, and Notification of Personal Rights.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/06/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BOYD, SHERRI A.
FACILITY NUMBER: 410507023
VISIT DATE: 04/06/2022
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
The Licensee states that Fire and Earthquake drills are conducted every six months. The last drill was conducted in November 2021. During the inspection, LPA reviewed the children's, Licensee's, and helper's records. LPA observed that the Licensee maintained records of each child accordingly; identification and emergency information, immunization, consent for medical treatment, and parent's rights were appropriately completed and maintained in their respective files. The Licensee has a record of immunization. Licensee CPR is valid until 12/4/2023, and Mandated Reporter Training is valid until 5/9/2022.

LPA discussed the safe sleep regulations with the Licensee and discussed the Child Care Licensing Safe Sleep webpage https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the 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.

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.

Incidental Medical Services (IMS) was discussed with Licensee. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BOYD, SHERRI A.
FACILITY NUMBER: 410507023
VISIT DATE: 04/06/2022
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
The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

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 at www.cdss.ca.gov/inforesources/community-care-licensing/process.

The report was reviewed and signed by the Licensee, Sherri Boyd. No deficiencies were observed in today's inspection. Today's report, 4/6/2022, and notice of site visit will be sent to the Licensee email by the close of business on 4/6/2022. Confirmation of receipt is required, and a notice of site visit must remain posted for 30 days.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3