554501376-3-11-2025-53-CC-DKHE-DENQLM-20250311121610

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 554501376
Report Date: 03/11/2025
Date Signed: 03/11/2025 12:16:53 PM

Document Has Been Signed on 03/11/2025 12:16 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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME:	JOHNSON, LEAH		FACILITY NUMBER:	554501376
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS:	DATE:	03/11/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Johnson, Leah		TIME VISIT/ INSPECTION COMPLETED:	12:30 PM

NARRATIVE

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On February 11, 2025, at 9:30 AM, Licensing Program Analysts (LPA) Deborah Khashe met with applicant, Leah Johnson for the purpose of a pre licensing inspection. The purpose of the inspection was explained. LPA Khashe was granted entry into the facility by applicant. All individuals subject to criminal background review have obtained a criminal record clearance. Licensee’s hours are Monday through Friday from 7:30 AM to 6:00 PM. Breakfast, Lunch, and snacks will be provided to day care children. Water will be served from tap or refrigerator.

A health and safety inspection were conducted inside and out. The detached two-story and single-family home consists of four (4) bedrooms and three (3) bathrooms. The off-limits include all main floor bedrooms and master bathroom, laundry room and garage. The on limits include, downstairs bedrooms 1 and 2 and bathroom, kitchen, dining room, living room and bathroom. The off-limits areas will remain inaccessible to daycare children by closed locked doors, doorknob covers, and SUPERVISION.

Outdoor play area was toured. Licensee, Leah Johnson stated there are no bodies of water on the premises. Applicant stated that none of her direct neighbors has an in-the-ground pool or above-the-ground pool. LPA toured the bathrooms and verified toxic and hazardous items were inaccessible to children in care. Functioning smoke and carbon monoxide detectors were observed in the hallway. LPA observed cleaners are inaccessible to children in care. 3A40BC fire extinguisher and first aid kit were observed. Applicant stated there are weapons in the home. The weapons are stored in a locked safe separate from the ammunition that is stored in a lock cabinet. LPA discussed the new Mandated Reporter Training with applicant. Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/. The training is currently provided in English. Applicant has current Mandated Reporter Training Certificate that expires on 11-21-26. Current pediatric CPR and first aid training's were verified and expires on 10-20-2026.

Report continues 809-C….

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Deborah Khashe
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: JOHNSON, LEAH	FACILITY NUMBER: 554501376
	VISIT DATE: 03/11/2025

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809C
Licensee will provide Incidental Medical Services. 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) or (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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at 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. LPA discussed the requirement to check and log infant napping every 15 minutes, for infants under 24 months. LPA provided Licensee a copy of LIC 9227—Individual Infant Sleeping Plan. LPA discussed the requirement to complete the LIC 9227—Individual Infant Sleeping Plan for infants under twelve (12) months of age.

LPA discussed the Year-Round/Daily Reminder of Water Safety Requirements and Measures with licensee. LPA provided licensee the PIN 23-17-CCLD, the Year-Round and Daily Reminder of Water Safety Requirements and Measures. LPA discussed with licensee the importance of checking the premises for bodies of water daily prior to children’s arrival for children’s safety.

LPA reviewed with applicant 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. Entrance Checklist was provided to the applicant.

Applicant was encouraged to visit the department website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to family child care homes. LPA also provided the e-mail address for the advocates in order to be added to the quarterly newsletter mailing list. childcareadvocatesprogram@dss.ca.gov

Report continues on LIC 809C1

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Deborah Khashe
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: JOHNSON, LEAH	FACILITY NUMBER: 554501376
	VISIT DATE: 03/11/2025

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809C1
Applicant understands that anyone living or working in the home, eighteen (18) years of age or older must obtain fingerprint clearance PRIOR to living or working in the home. Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.
Applicant understands that licenses are not transferable, and once licensed, licensee and co licensee must live in the home and be present for 80% of the operating hours. Applicant understands that if an unusual incident occurs; licensing is to be notified via phone call, e-mail or fax within 24 hours, and the Unusual Incident Report LIC 624 shall be submitted within seven (7) days to remain in compliance. Applicant understands that if any structural changes are made to the home; licensing must be notified prior to construction.
Applicant understands that if they want to make any off-limit area an ON-limits area, they must notify licensing, and LPA must do an inspection BEFORE children are allowed in the area. Applicant understands that children’s records are to be maintained according to Title 22 regulations and be accessible to licensing for up to three (3) years.
Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.
On this date, 3/10/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Report continues on LIC 809C2

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Deborah Khashe
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

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
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: JOHNSON, LEAH	FACILITY NUMBER: 554501376
	VISIT DATE: 03/11/2025

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809C2

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PINs), Program Quarterly Update Newsletters and other important information communication platforms.

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.

This facility evaluation report was reviewed and discussed with the applicant, Leah Johnson. Effective today 03/11/2025, applicant is approved for Small Family Child Care Home license for a capacity of 6 children with no more than 3 infants, or 4 infants only, or up to 8 children with no more than 2 infants, 1 child in Transitional Kindergarten or above and 1 child at least age 6. Infants are children under the age of 2.

SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Deborah Khashe
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025

LIC809 (FAS) - (06/04)

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