480111823-5-11-2023-01-CC-EHTS-CRQSRL-20230511140632

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 480111823
Report Date: 05/11/2023
Date Signed: 05/11/2023 02:06:44 PM

Document Has Been Signed on 05/11/2023 02:06 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME:	WILLIAMS-MCNEALLY, KAY FCCH		FACILITY NUMBER:	480111823
ADMINISTRATOR:	WILLIAMS-MCNEALLY, KAY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 429-3125
CITY:	FAIRFIELD	STATE: CA	ZIP CODE:	94533
CAPACITY: 12	TOTAL ENROLLED CHILDREN: 7	CENSUS: 7	DATE:	05/11/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:38 AM
MET WITH:	Licensee Kay Williams- McNeally		TIME COMPLETED:	02:10 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	An annual inspection was made to the facility by Licensing Program Analyst (LPA), Elpidia Hernandez Torres. A review of staff records on 05/10/23 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently two adults living in the home. During today’s inspection the home and grounds were toured. Upon LPA's arrival The licensee was supervising six children, three infants and three preschool aged children. Shortly after LPA arrived child (C1) arrived making the facility out of ratio. Licensee called Volunteer (R1) to help. R1 was not a qualified assistant, deficiency was issued. No children were observed left in any parked vehicle. The facility’s operating hours are 07:30AM to 06:00PM, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are all four bedrooms, and the back yard. They were made inaccessible by door knob slip covers, and door blocking mechanisms. The home was clean and orderly, and was at a comfortable indoor temperature. There were safe toys and equipment available for children. Licensee has valid AB 1207 mandated reporter training certificate which expires on 03/2024. The last disaster drill was a fire drill that was conducted on 05/02/2023. There is a working telephone in the home. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) were stored out of the reach of children. Poisons are locked with a key or combination lock. The fireplace has been made inaccessible with shelves and toys. There is a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The licensee stated there are no firearms and/or other dangerous weapons in the home, and none were observed during today's inspection. The children use the back enclosed patio as the outdoor play area. There were no pools or other bodies of water observed. Seven children's records were reviewed at 11:09AM; required emergency information was observed to be on file. Three infants; C2,C3, C7 were missing Sleep Logs, deficiency was issued.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: WILLIAMS-MCNEALLY, KAY FCCH	FACILITY NUMBER: 480111823
	VISIT DATE: 05/11/2023

NARRATIVE

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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.

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 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 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

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Kay Williams-McNeally.

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.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:	DATE: 05/11/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/11/2023 02:06 PM - It Cannot Be Edited

Created By: Elpidia Hernandez Torres On 05/11/2023 at 01:34 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
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: WILLIAMS-MCNEALLY, KAY FCCH	FACILITY NUMBER: 480111823
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/11/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)

Infant Safe Sleep

The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, record review, Three infants in care C2, C3, C7 only had Sleep Logs documented up to 12 months, not 24 months.The licensee did not comply with the section cited above which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/25/2023
	Plan of Correction
1 2 3 4	Licensee agreed to submit the sleep log for C2,C3, and C7 for the week of 05/15/23 to LPA Hernadnez Torres via email, mail or fax on or before 05/25/2023.

Type B

Section Cited

CCR

102416.5(b)(3)

Staffing Ratio and Capacity

(b) For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be one of the following: (3) More than six and up to eight children, without an additional adult attendant, only if the criteria in Section 1597.44 of the Health and Safety Code are met. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, LPA arrived there were six children present with licensee. Shortly after LPA's arrival, a 7th child (C1) arrived to the facility. There were three infants, and four preschool ages children. None of the children were six years old or attending school. The licensee did not comply with the section cited above which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/18/2023
	Plan of Correction
1 2 3 4	LPA asked licensee if she could call her assistant. Licensee called volunteer (R1) to help during lunch time with the day care. LPA asked R1s age, R1 was not the age of a Qualified assistant. Qualified Assistant arrived one hour after lunch time at 12:30PM. LPA printed the FCCH ratio regulations and reviewed them with licensee. Licensee reported in the future her qualified assistant will take two children with them, so the licensee stays with in ratio in the home.

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:

Leslie Lepori

LICENSING EVALUATOR NAME:

Elpidia Hernandez Torres

LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2023

LIC809 (FAS) - (06/04)

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