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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434413720
Report Date: 03/02/2023
Date Signed: 03/02/2023 10:51:47 AM

Document Has Been Signed on 03/02/2023 10:51 AM - 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:FULTON, DENISEFACILITY NUMBER:
434413720
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
03/02/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:16 AM
MET WITH:Denise FultonTIME COMPLETED:
11:20 AM
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
Licensing Program Analyst (LPA), Janette Cruz, conducted an unannounced case management inspection in response to Licensee's request to increase the capacity from 8 to 14 children. LPA met with Denise Fulton, Licensee. LPA also observed Anthony Fulton (Licensee's adult son) with four preschool children and two infants present in the home during today's inspection. The Licensee, her son, Anthony, Licensee's spouse, Eric Fulton, and Licensee's minor daughter (11-year old) are residing in the home. Days and hours of operations are from Monday to Friday from 7:30 AM to 4:30 PM. Licensee has current CPR/First Aid certifications and Mandated Reporter Training certificate on file. Both indoor and outdoor areas of the home were inspected.

LPA observed the two-story home is clean, orderly, and safe for the day care children. LPA observed a barricaded fireplace, LPA observed sufficient age-appropriate materials, toys, and play equipment in the facility. Off limit areas indoor: upstairs - bedroom, one bathroom and family room; downstairs - Master bedroom/bath, one bedroom, living room and attached garage. There are no bodies of water observed. Backyard is fenced. Off limits outdoor: right side of home that is fenced off to children.

LPA observed a fully charged 2A10BC fire extinguisher and a working smoke/carbon monoxide detectors Licensee has a pet dog (Breed- Cattle) in the home. All cleaning compounds and medications are adequately stored in high or locked cabinets inaccessible to children.

Licensee states that she does not administer medication at this time. 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 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: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: FULTON, DENISE
FACILITY NUMBER: 434413720
VISIT DATE: 03/02/2023
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
LPA obtained a copy of children's roster. LPA reviewed staff and children's files.
A review of staff records during today's inspection indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

LPA reviewed with the Licensee 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.

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.

Fire clearance was granted on 02/8/2023.

No deficiency was cited during today's inspection. LPA conducted an exit interview with Denise Fulton. Licensee and was advised that a large family child care home license will be approved upon completion of the following:
1. Photo of A/C condenser unit at the backyard covered, barricaded or made inaccessible to children
2. Photo of safety gate to barricade access to stairs going to second floor of the home
3. Review and approval by Management.

A Notice of Site Visit was issued and must remain posted for 30 days.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
Page: 2 of 2