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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416735
Report Date: 10/06/2022
Date Signed: 10/06/2022 04:04:51 PM

Document Has Been Signed on 10/06/2022 04:04 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:SCHILL, ASHLEYFACILITY NUMBER:
434416735
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
10/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Ashley SchillTIME COMPLETED:
02:15 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
Licensing Program Analyst (LPA) Samantha Yip conducted an unannounced Required- 1 Year inspection. LPA met with Licensee Ashley Schill and explained the reason of the inspection. Licensee also applied for a change of capacity for a large Family Child Care Home (FCCH). Licensee has been licensed since 08/17/2021; therefore, she has the one year of experience to apply for large FCCH. Present during today's inspection were Licensee, her father, and 5 children, whom 2 were infant age.

LPA toured the inside and outside of the home. The off-limit areas of the home are the entire upstairs, and garage. There are stairs and a fireplace in the home, which are barricaded. Licensee removed barricaded on the lower stairs due to breaking. Licensee is in the process of installing a new gate. During today's inspection, LPA observed a child going into the kitchen to get their water bottles from the fridge and to wash hands. LPA discussed with Licensee that she needs to notify Licensing if she wants to change an area to on-limits. Licensee also requested to make the dining room on-limits. LPA inspected the room and observed that it is safe for children. LPA observed that there were knives in the drawer, which are accessible to children. LPA discussed with Licensee about ensuring any areas that are off-limit are inaccessible to children. Licensee will put gate to block the dining room area. LPA also discussed with Licensee that anything that states to keep out of reach of children needs to be inaccessible, such as disinfectant wipes and sprays. There are toys for children and equipment were observed to be age-appropriate. There is a fully charged fire extinguisher, smoke detector, and carbon monoxide detector. The last disaster drill was conducted on 10/06/2022. LPA reminded Licensee that fire/disaster drills need to be conducted every 6 months and documented.

--------------------continues on 809 dated 10/06/2022 page 2---------------------
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2022
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 6
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: SCHILL, ASHLEY
FACILITY NUMBER: 434416735
VISIT DATE: 10/06/2022
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
----------------continuation of 809 dated 10/06/2022 page 1---------------------

The backyard is used and is fenced. The off-limit areas outside are the right and left side of the home. There is a play structure, which is anchored to the ground. LPA reminded Licensee to check for any cracks on the play structure. There were no bodies of water observed during today's inspection.

LPA discussed the safe sleep regulations with licensee 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 discussed with Licensee that 15 minute sleep check for infants (2 years and younger) need to be conducted and documented. Sleep check log needs to include the child's name, date, and the time that they were checked. 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.

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: http://www.ada.gov/childqanda.htm.



A copy of the facility roster was obtained. Five (5) children's files were reviewed during today's inspection. The records reviewed include but not limited immunization records.

--------------------continues on 809 dated 10/06/2022 page 3----------------------
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: SCHILL, ASHLEY
FACILITY NUMBER: 434416735
VISIT DATE: 10/06/2022
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
-----------------continuation of 809 dated 10/06/2022 page 2---------------------

Licensee completed the Mandated Reporter training on 07/15/2021 and has a valid CPR/1st Aid, which expires on 05/08/2023. LPA reminded Licensee that the Mandated Reporter training requires renewal every two years. Licensee's immunization records for measles and pertussis are on file. LPA reminded Licensee that she needs to obtain updated influenza or decline of influenza.

LPA discussed with Licensee about the maximum capacity requirement of a Large Family Child Care Home License. The maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home shall be either:
(1) 12 children, no more than four of whom may be infants; or
(2) more than 12 and up to 14 children if at least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age and there are no more than three infants being cared for during any time when more than 12 children are being cared for.

When Licensee have more than 12 and up to 14 children in the home, Licensee must notify the parent using the form LIC9150 “Parent Notification Additional Children in Care." LPA reminded Licensee that when Licensee does not have a Helper, Licensee can only care for up to 8 children at any one time in the home.

The adults living in the home that are 18 and older are Licensee, her spouse, and her father. Licensee also has three minor children. All adults have cleared fingerprints or exemption. 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.

--------------------continuation of 809 dated 10/06/2022 page 4------------------
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: SCHILL, ASHLEY
FACILITY NUMBER: 434416735
VISIT DATE: 10/06/2022
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
----------------continuation of 809 dated 10/06/2022 page 3----------------------

Licensee will submit the following:
- updated LIC 999A
- sleep log infant that includes the date, child's name, and time checked.
- proof Lower stair are barricaded

LPA Samantha Yip informed Licensee Ashley Schill that this report dated 10/06/2022 documents two Type A citations which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Samantha Yip informed the Licensee to provide a copy of this licensing report dated 10/06/2022 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

As a result of this inspection, Type A and Type B deficiencies were issued. Exit interview conducted and report was reviewed with the Licensee, Ashley Schill.

LPA advised facility representatives upon approval of Licensing Management, a license for large FCCH will be granted and issued to Licensee upon completion of:
- submitting an updated LIC 999A to reflect the change in on-limit areas
- proof that lower stairs are barricaded

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Samantha Yip
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 10/06/2022 04:04 PM - It Cannot Be Edited


Created By: Samantha Yip On 10/06/2022 at 12:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SCHILL, ASHLEY
FACILITY NUMBER: 434416735

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/06/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited, which poses an immediate health, safety or personal rights risk to persons in care. LPA observed that there were knives in the kitchen drawer, which is accessible to children.
POC Due Date: 10/07/2022
Plan of Correction
1
2
3
4
Licensee moved knives to the corner where it is inaccesible to children during today's inspection.
Type A
Section Cited
CCR
102416.3(a)(6)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to persons in care. Licensee uses the kitchen for the children, which is indicated on the LIC 999A as off-limits.
POC Due Date: 10/07/2022
Plan of Correction
1
2
3
4
By POC 10/07/2022, Licensee will submit an updated LIC 999A to reflect the change to the on-limit area.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 10/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/06/2022


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 10/06/2022 04:04 PM - It Cannot Be Edited


Created By: Samantha Yip On 10/06/2022 at 12:40 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: SCHILL, ASHLEY
FACILITY NUMBER: 434416735

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/06/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above, which poses a potential health, safety or personal rights risk to persons in care. Licensee is not documenting that infants are checked every 15 minutes when napping.
POC Due Date: 10/14/2022
Plan of Correction
1
2
3
4
By POC 10/14/2022, Licensee will submit sleep log for infants, which includes the date, name of the child, and time checked.
Type B
Section Cited
CCR
102417(g)(9)(A)(g)
The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above, which posed a potential health, safety or personal rights risk to persons in care. Licensee has not conducted a disaster drill with children.
POC Due Date: 10/06/2022
Plan of Correction
1
2
3
4
Deficiency was corrected during today's inspection. Licensee conducted disaster drill with children during today's inspection.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Joel Segura
LICENSING EVALUATOR NAME:Samantha Yip
LICENSING EVALUATOR SIGNATURE:
DATE: 10/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/06/2022


LIC809 (FAS) - (06/04)
Page: 6 of 6