434407717-5-26-2022-07-CC-JCRZ-CESPTE-20220526113550

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434407717
Report Date: 05/26/2022
Date Signed: 05/26/2022 11:36:02 AM

Document Has Been Signed on 05/26/2022 11:36 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:	PARRISH, KELLEY		FACILITY NUMBER:	434407717
ADMINISTRATOR:	PARRISH, KELLEY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(408) 768-5717
CITY:	SAN JOSE	STATE: CA	ZIP CODE:	95119
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 8	DATE:	05/26/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:13 AM
MET WITH:	Kelley Parrish & Raquel Parrish		TIME COMPLETED:	11:50 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 met with Kelley Parrish, Licensee, for an unannounced Required 1-year annual inspection. LPA was granted access to the home by the Licensee. LPA also observed Licensee's daughters/adult assistants, Renee Parrish, Raquel Parrish five preschool day care children and three infants present in the home during today's inspection. The Licensee was operating within her capacity and ratio requirements. LPA observed the required postings, including the facility license, posted inside the home. Days and hours of operation are Monday - Friday from 6:30 AM to 5:00 PM. Licensee stated that she and her daughters, Renee & Raquel Parrish and boyfriend, Carl Neal, are the adults residing in the home. There are no active waivers for this facility. LPA reviewed a current Child Care Facility Roster and Fire/Disaster drill log during today's inspection. The last fire/disaster drill was completed on 01/10/2022. Licensee does not have an active Child Care Liability Insurance. Licensee has the required vaccinations (MMR, Tdap, & flu). LPA reviewed Licensee's and adult assistant's Mandated Reporter Training for Child Care Workers (valid 12/16/2023). LPA also reviewed Licensee's and adult assistant's Pediatric First Aid & CPR Training certifications (valid 03/2023). LPA reviewed ten children's files which were complete with the required forms. LPA discussed the safe sleep regulations with the 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 the 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.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PARRISH, KELLEY	FACILITY NUMBER: 434407717
	VISIT DATE: 05/26/2022

NARRATIVE

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LPA toured the indoor and outdoor areas of the home during today's inspection. Licensee has a working telephone in the home. LPA observed sufficient materials, toys, and play equipment for the day care children. Licensee states that a child will be isolated in the living room area of the home if necessary due to illness or communicable disease.

LPA observed the home is clean, orderly, and safe for the day care children. LPA also observed a screened fireplace. There are no open face heater units. LPA observed barricaded stairs inside the home. Off limit areas in the home: entire second floor with four bedrooms and two bathrooms. LPA observed a fenced pool, at least 5 feet high, does not obscure the pool from view . The gate on the fence swings away from the pool, self-closed and has a self-latching device located no more than six inches from the top of the gate.

LPA observed a fully charged 3A40BC fire extinguisher, working smoke/carbon monoxide detectors and fenced backyard. Licensee stated she does not have any weapons in the home. Licensee states that she a pet dog (chihuahua mix) in the home. All detergents, cleaning compounds, medications, and other similar items are inaccessible to children. The Licensee states that she does not administer medication to the day care children.

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

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.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022

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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: PARRISH, KELLEY	FACILITY NUMBER: 434407717
	VISIT DATE: 05/26/2022

NARRATIVE

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Supervision of children was discussed with Licensee and she understands that she must be present in the home during day care hours and ensure that the children are supervised at all times. The Licensee understands her capacity options and she
understands that she cannot have more than 14 children in the home at any time without a fully qualified adult present. Licensee states that she transports day care children. The Licensee understands that children shall not be left unattended in parked vehicles and that car seats shall only be used for transportation and shall not be used for sleeping.

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.

LPA provided Licensee with website resources on managing food allergies at school and handling medical emergencies related to food allergies.

CDC Managing Food Allergies at School
https://www.cdc.gov/healthyschools/foodallergies/index.htm

American Academy of Pediatrics Healthy Children Medical Emergencies
https://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/When-to-Call-Emergency-Medical-Services-EMS.aspx

Exit interview conducted and report was reviewed with the Licensee's daughter, Raquel Parrish. A deficiency was issued during today's inspection.

A Notice of Site Visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Janette Cruz
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 05/26/2022 11:36 AM - It Cannot Be Edited

Created By: Janette Cruz On 05/26/2022 at 11:13 AM

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: PARRISH, KELLEY	FACILITY NUMBER: 434407717
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/26/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not comply with the section cited above. Licensee's did not maintain an Individual Infant Sleeping Plan (LIC9227) and every 15-minute physical sleep check documentation included in the infant's file which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/24/2022
	Plan of Correction
1 2 3 4	Licensee will submit to LPA the Individual Infant Sleeping Plan (LIC 9227) and 15-minute physical safe sleep check documentation for infant enrolled in care by POC 06/24/22.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Diana Stephenson

LICENSING EVALUATOR NAME:

Janette Cruz

LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022

LIC809 (FAS) - (06/04)

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