503907958-12-31-2024-04-CC-STOE-DCGPN4-20241231102715

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 503907958
Report Date: 11/28/2023
Date Signed: 12/31/2024 10:28:17 AM

Document Has Been Signed on 12/31/2024 10:28 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	MILLER, SHANNON & PEEL, CAROLYN FAMILY CHILD CARE		FACILITY NUMBER:	503907958
ADMINISTRATOR:	MILLER, SHANNON & PEEL, CA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 526-2002
CITY:	MODESTO	STATE: CA	ZIP CODE:	95355
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	11/28/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Shannon Miller		TIME COMPLETED:	12:00 PM

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On 11/27/2023 at 9:30 a.m., Licensing Program Analyst (LPA) Valerie Mireles conducted an unannounced Triennial Required Inspection and was met by licensees, Shannon Miller and Carolyn Peel. Also present was Shannon Miller’s adult child. LPA toured the home inside and outside and a census was taken. There were five children supervised by the co-licensees. Days and hours of operation are Monday through Friday from 7:30 a.m. to 5:30 p.m.

LPA reviewed the current facility sketch and Shannon Miller confirmed that the living room (day care room), downstairs bathroom, kitchen, two dining rooms, and the backyard are accessible for children to use. This is a two-story home. There are two child safety gates on each side of the hallway at the base of the stairs to prevent children from accessing stairs and second story of the home. There are pets at this home. Licensees understand responsibility of any action taken by pets involving daycare children. All other rooms are off-limits and made inaccessible by use of locked doors. Safe toys and play equipment are observed. There is one fireplace in the home located in the living room, which is off limits, and is made inaccessible by a glass door and will not be in use during daycare hours. There is a working fire extinguishers, smoke detectors, carbon monoxide detector and adequate heating and ventilation for safety and comfort. The most recent fire drill was conducted on 11/03/2023. The home has working telephone service and LPA confirmed the phone number is (209) 818-1285.

There is no swimming pool or other bodies of water on the premises. Licensee states there are no firearms or ammunition on the premises. No poisons were observed during today’s inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. Licensees ensures that children in care are supervised at all times and are aware children shall not be left in parked vehicles. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

Continued to LIC809-C.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MILLER, SHANNON & PEEL, CAROLYN FAMILY CHILD CARE	FACILITY NUMBER: 503907958
	VISIT DATE: 11/28/2023

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LPA reviewed a sample of children’s files and observed the files were complete with emergency information as required. Both Licensee’s Mandated Reporter Training was completed on 01/04/2022. Both Licensee’s pediatric CPR/First Aid certification expires on 05/27/2025. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed 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-andresources/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 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: https://www.ada.gov/resources/child-care-centers/.

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.

Cotninued to LIC809-C.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: MILLER, SHANNON & PEEL, CAROLYN FAMILY CHILD CARE	FACILITY NUMBER: 503907958
	VISIT DATE: 11/28/2023

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Exit interview conducted and report was reviewed with licensee Shannin Miller. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are being cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. Licensee was provided appeal rights.

SUPERVISORS NAME: Cynthia Brannon
LICENSING EVALUATOR NAME: Valerie Mireles
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

LIC809 (FAS) - (06/04)

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