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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073409280
Report Date: 06/16/2023
Date Signed: 06/16/2023 10:27:34 AM

Document Has Been Signed on 06/16/2023 10:27 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:HONEY, SADE & JONES, CHEYENNEFACILITY NUMBER:
073409280
ADMINISTRATOR:HONEY, SADEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 477-1453
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 7DATE:
06/16/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Angelo WilsonTIME COMPLETED:
10:30 AM
NARRATIVE
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On 06/16/2023 at 9:30 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced Case Management inspection at Sade Honey and Cheyenne Jones large child care home. LPA met with aide, Angelo Wilson and explained the purpose of today’s inspection. Neither Sade Honey nor Cheyenne Jones were present during inspection. During today's inspection, there were 7 children in care (6 preschool and 1 school age child.) Aide has Criminal Record Clearance.

LPA initially was following up on a Plan of Correction cited 05/24/2023 for Altering Existing Grounds and Buildings. Facility was using an off limit area for children for entering and exiting facility as well as their belongings. During today's inspection, LPA Watts did observe that parents/authorized representatives are using the front door for entrance and exit. LPA also did not observed any children in the garage. As of 06/16/2023, deficiency has been CLEARED and a clearance letter was printed and provided for facility.

During today's inspection, LPA was greeted by Assistant, Angelo Wilson. When asked if aide has CPR/First Aid certificate, aide stated that they have a valid CPR/First Aid certificate however does not know where the files are kept for children and staff. Aide also stated that they do not have proof currently. LPA also requested proof of Mandated Reporter and aide stated Mandated Report training is updated however cannot provided proof. Aide was unable to provide LPA staff files when requested which is a violation of California Code of Regulations, Title 22.

*SEE LIC 809-D FOR DEFICIENCIES*

Exit interview conducted and report was reviewed with the Aide, Angelo Wilson. A notice of site visit was given and must remain posted for 30 consecutive days.

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2023
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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Document Has Been Signed on 06/16/2023 10:27 AM - It Cannot Be Edited


Created By: Christina Watts On 06/16/2023 at 10:01 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: HONEY, SADE & JONES, CHEYENNE
FACILITY NUMBER: 073409280

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/19/2023
Section Cited
CCR
102416.1(a)

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102416.1 Personnel Records (a) Personnel records shall be maintained on each employee and shall contain the following information...This requirement has not been met as evidenced by:
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By COB 06/19/2023, Faciliity will have to provide licensing a copy of staff file which should include: Mandated Reporter, CPR/First Aid certificate, immunizations.
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Based on observation, the licensee did not comply with the section cited above when facility was not able to provide staff files which poses an potential risk to the health, safety or personal rights 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:Christina Watts
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2023


LIC809 (FAS) - (06/04)
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