<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005441
Report Date: 03/22/2021
Date Signed: 03/22/2021 04:57:51 PM

Document Has Been Signed on 03/22/2021 04:57 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:STIFFLER, SHARON A.FACILITY NUMBER:
214005441
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
03/22/2021
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Sharon StifflerTIME COMPLETED:
12:00 PM
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), Farhan Bashir-Tariq conducted a scheduled case management inspection for capacity increase today and met with Licensee, Sharon Stiffler. This inspection was conducted via Face Time due to COVID-19 restrictions. Purpose of the inspection was explained. LPA verified the background check clearance of adults working or living in the home. Licensee lives with her son. Licensee owns the home, which consist of two bedrooms and two bathrooms. Hours of operation are: M-F, 8:00 am- 5:30 pm. Licensee provides two snacks and children bring their own food. Daycare areas: Back yard, Front yard, Upper Level: Living Room/Play area, Bathroom #1, Bedroom #1 and #2 for napping only. OFF limit areas: Upper level: Bathroom #2 ,Kitchen, Lower level: Garage and Storage rooms. Garage was previously used as main day care area, which is now off limit. Living room/Play area at the upper level will now be used as main childcare area. Licensee advertises her services as Learning Tree Day Care.

LPA and Licensee virtually inspected the entire home for health and safety hazards. All off limit areas were properly barricaded and made inaccessible to the children in care. Living room/Play area on upper level will be used as main childcare area. Stairs leading to upper level were blocked off with baby gates at top and bottom. License and other required licensing documents were observed to be posted by the main door. Home was observed to be clean and orderly with enough lighting and ventilation. Kitchen on upper level is located next to play area, which has been blocked off with a baby gate. Toxins and Chemicals were observed to be stored inaccessible to children in care. All harmful and sharp objects were made inaccessible from children in care.

Home has multiple smoke and carbon monoxide detectors available. Licensee tested the detectors for this inspection. A working telephone and a fully charged fire extinguisher of size 2A10BC or bigger is also available in the home. First Aid Kit were fully stocked and stored in emergency back packs. License states that are no firearms or weapons present in home. Per Licensee, there is a hot tub in the back yard. LPA observed that hot tube was secured and blocked off with a locked cover on it. Back yard and front yard were observed to be fully fenced all around. LPA observed that there were plenty of toys, books and other learning and playing materials available in the home and in front and back yards.

Licensee was reminded to conduct and log a fire and emergency drill once every six months. Licensee has a current and valid First Aid and CPR card expiring in April 2021. Licensee was reminded of NO walker, exersaucers, jumpers, bouncers and any similar items to be used for children in care and shall be made inaccessible. Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. During the visit, LPA also provided information and assistance about issues related to COVID-19. Licensee was reminded to clean and disinfect day care areas thoroughly at least once a day. Licensee was instructed to post COVID-19 symptoms and social distancing posters in childcare area and hand washing poster in bathroom.
Continuation on next page....
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: STIFFLER, SHARON A.
FACILITY NUMBER: 214005441
VISIT DATE: 03/22/2021
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
26
27
28
29
30
31
32
LPA reminded Licensee that All adults, 18 years and older living in the home, helper, or assistant must have finger print clearance and must be associated to the facility by submitting an LIC 9182 with a copy of CDL or CA. ID prior to having any contact with children in care failure to do so could result in an immediate civil penalty. LPA reminded Licensee that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPA reminded Licensee , as of January 1, 2018, all staff is required to complete Mandated Child Abuse Reporter Training (AB1207) every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encouraged Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.


Large Family Child Care Home License is pending and will be approved upon receiving the following items:
i. Fire clearance from Ross Valley Fire Department.
ii. A valid Mandatory Child Abuse Training Certificate from Licensee.
iii. COVID-19 Self-Assessment Guide completed by Licensee.

This report will be kept in the facility file and will be made available for public review upon request. Desk duty is available M-F, 8AM-5PM at (650) 266-8800. Website for forms and Regulations: www.cdss.ca.gov
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2