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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408747
Report Date: 07/29/2021
Date Signed: 07/29/2021 05:50:40 PM

Document Has Been Signed on 07/29/2021 05:50 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:MCCAULEY, LATASHAFACILITY NUMBER:
073408747
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
07/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Latasha MccauleyTIME COMPLETED:
06:00 PM
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On 7/29/21 at 3:00 PM Licensing Program Analyst (LPA) Michelle Sutton conducted an unannounced Annual inspection with Latasha Mccauley Family Childcare Home. LPA met with Latasha and explained the purpose of today's inspection. LPA was granted the inspection authority to enter the Home. The family Childcare Home days and hours are Monday to Friday 6:30 AM to 5:30 PM. Present in the home at time of inspection were licensee, assistant, 4 preschool age children, 2 school-age, licensee's 10 year old grand daughter and 7 year old grandson who is here just for today.

Indoor Space: At 3:15 PM A health and safety tour of inside the home was done. LPA toured the premises with licensee. The home is sanitized and orderly in compliance with Title 22 Regulations at this time. There is a 2A10BC fire extinguisher, working smoke alarm and carbon monoxide detector in the home. The home is a two stories consisting of living room, dining room, family room, kitchen, laundry room, loft, 4 bedrooms and 3 bathrooms.

The OFF-LIMIT areas are downstairs master bedroom/bath, laundry room, entire upstairs/loft, garage which includes a spare room and the gated off area of the backyard. These areas are inaccessible to children in care by closed and locked doors, visual supervision and a safety gate at the bottom of the stairs. IN-USE The living room, family room, kitchen, hall bathroom and backyard are the primary areas for day-care. Medicines, cleaning products, sharp objects are stored inaccessible to children in cabinets and draws with latches. LPA reminded licensee that smoking, baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. Licensee states that there is 2 dogs and no arms and ammunition stored in the homend. The fireplace is screened, and the home maintains a working telephone.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: MCCAULEY, LATASHA
FACILITY NUMBER: 073408747
VISIT DATE: 07/29/2021
NARRATIVE
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Outdoor Space: AT 3:45 PM LPA toured the outdoor area (backyard) and observed it was fenced. LPA observed a play structure in backyard. LPA discussed with licensee to email an updated backyard facility sketch. LPA reminded licensee when children are outside playing with water there needs to be 100% supervision. LPA observed there are no pools, hot tubs or other bodies of water.

Children files and Facility files were reviewed. Facility contained Children's Roster, assistant and licensee completed pediatric CPR and first aid which expires 6/21/2023, immunization against influenza, pertussis, measles and influenza vaccination verification. Licensee and Assistant is missing mandated reporter training. LPA discussed the requirements for Children's files.

Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. Licensee is encouraged to visit the Department’s website at www.cdss.ca.gov to access resources for Providers, Title 22 Regulations, Online option to pay Annual License fee, Adoption of new Laws, etc.


Licensee is registered for quarterly updates/PINs.

At 5:30 PM Exit Interview was conducted with Latasha where this report and citations was reviewed and discussed. Report was signed by the licensee confirming receipt of documents. A NOTICE OF SITE VISIT WAS ISSUED, AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE HOME FOR 30 CONSECUTIVE DAYS AND APPEAL RIGHTS WERE GIVEN.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Michelle Sutton
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021
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Document Has Been Signed on 07/29/2021 05:50 PM - It Cannot Be Edited


Created By: Michelle Sutton On 07/29/2021 at 04:40 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: MCCAULEY, LATASHA
FACILITY NUMBER: 073408747

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/26/2021
Section Cited
HSC
1059.8662(4)(b)(1)

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On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter
training provided [...] and shall complete renewal mandated reporter training every
two years[...]. .This requirement is not met as evidenced by:
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By 8/26/2021 Licensee and asistant must submit proof of Mandated Reporting Training per AB1207 Child Care Providers
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Per LPAs observation and file review, licensee and assistant have no proof of current mandated reporter training. This is a potential risk to health and safety of children in care
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Assistant shall complete General and Childcare Providers sections. Licensee requires Child Care Providers certification only.
mandatedreporterca.com
Type B
08/26/2021
Section Cited
CCR102417(g)

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102417(g) OPERATION OF FAMILY CHILDCARE HOME: The home shall be free from defects or conditions which might endanger a child. [...] This requirement is not met as evidenced by
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By 8/26/2021 Licensee must submit proof of AC unit inaccessible to children.
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LPA observered an AC unit in the backyard that did not have any fence/cover and was accessible to children. This is a potential risk to health and safety of children in care
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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:Sherelle Johnson
LICENSING EVALUATOR NAME:Michelle Sutton
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2021


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