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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293621739
Report Date: 03/08/2022
Date Signed: 03/08/2022 03:49:17 PM

Document Has Been Signed on 03/08/2022 03:49 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:MADDOCK, TYANAFACILITY NUMBER:
293621739
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
03/08/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:20 PM
MET WITH:Tyana Maddock - LicenseeTIME COMPLETED:
04:10 PM
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On Tuesday, March 8th, 2022, at 2:25pm, Licensing Program Analyst (LPA) Blake Morillas conducted a Case Management visit for the purpose of increasing capacity from 8 to 14 children. LPA informed the Licensee, Tyana Maddock, of the reason for the inspection. At 2:28pm, 6 preschool age children were observed along with the Licensee. The Fire Safety Inspection Clearance has been received and the home has been cleared for up to 14 children.

Licensee 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, 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.

At 2:29pm, LPA initiated a health and safety inspection of all areas accessible to children.

By request of the Licensee, the Off-limits are being updated and now include the Entire Upstairs, Laundry Room, Carport. The request is approved. The Licensee acknowledged that children may never enter these off-limit areas.

LPA observed posted License, Parent's Rights and current emergency disaster plan. A current roster of the enrolled children and fire drill log was observed.

Hazardous items were stored inaccessible to children in care. Licensee stated there are no weapons in the home. Fire extinguisher (2A10BC), carbon monoxide and smoke detector meet regulation. Toys appear to be safe. Stairs in the home are appropriately barricaded as well as the wood burning pellet stove.
Continued on LIC 809-C
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Blake Morillas
LICENSING EVALUATOR SIGNATURE: DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/08/2022
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: MADDOCK, TYANA
FACILITY NUMBER: 293621739
VISIT DATE: 03/08/2022
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Continuation of LIC 809

The backyard is fenced. The Licensee understands that in unfenced area’s 100% supervision of children is required. There is a spa at the home. The spa is covered and locked on all sides.

Licensee understands that prior to making alterations or additions to the home or grounds, the licensee shall notify the Department of the proposed changes.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.

Capacity increase is approved as of 3-8-2022.

The facility is licensed to serve a MAX. CAP(WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN 4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

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

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.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the licensee, Tayana Maddock.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Blake Morillas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022
LIC809 (FAS) - (06/04)
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