334843944-7-9-2021-10-CC-LEDS-C4RS44-20210709133206

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 334843944
Report Date: 07/09/2021
Date Signed: 07/09/2021 01:32:14 PM

Document Has Been Signed on 07/09/2021 01:32 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	MCCARTHER-MCKNIGHT FAMILY CHILD CARE HOME		FACILITY NUMBER:	334843944
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 5	DATE:	07/09/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Chantay McCarther-McKnight-Licensee		TIME COMPLETED:	01:40 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	On 07/09/2021 at 12:15 PM, Licensing Program Analyst (LPA) LaKesha Edwards, arrived at the facility for the purpose of conducting a Case Management Inspection. The licensee has applied to increase their capacity to that of a Large Family Child Care Home. A fire clearance was approved on 06/28/2021 by the Moreno Valley Fire Department. Present during this visit were the Licensee and assistant worker. COVID-19 Screening questions were conducted prior to entry. Licensing Program Analyst (LPA) LaKesha Edwards toured the facility, inside and out, records were reviewed and the following was observed: Normal days and hours of operation are: Monday through Friday, 5:00 AM to 8:00 PM OFF-LIMIT AREAS INCLUDE: Entire Upstairs, Laundry Room, Garage and Side of backyard · Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the licensee during this inspection. · All hazardous items inaccessible · Toxins locked · No guns or weapons present as of this date. LICENSEE Chantay McCarther-McKnight UNDERSTANDS ALL GUNS, WEAPONS AND AMMUNITION MUST BE KEY-LOCKED SEPARATELY AND MADE INACCESSIBLE PER TITLE 22 REGULATIONS. · Stairs are barricaded · The fireplace is properly screened · Verification of control of property on file (viewed grant deed) · Property owner/landlord notification and consent on file

SUPERVISORS NAME: Dawn Parker
LICENSING EVALUATOR NAME: Lakesha Edwards
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MCCARTHER-MCKNIGHT FAMILY CHILD CARE HOME	FACILITY NUMBER: 334843944
	VISIT DATE: 07/09/2021

NARRATIVE

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· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights forms are posted
· Pediatric CPR and First Aid Card - expire on 01/14/2022
· Health & Safety Certificate - completed on 01/04/2016, 1-Hour Lead Poisoning completed on 4/28/2021
· There are no bodies of water as of this date. Licensee Chantay McCarther-McKnight understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Clean, safe and age appropriate toys
· There are no toxic plants observed at this time.
· Current roster on file
· Documentation of fire drills on file, last fire drill was conducted on 6/18/2021
· Children’s records are complete
· Employee’s records are complete
· Criminal record clearances are required prior to all adults living or working in a Family Child Care Home. A civil penalty of $100.00 per day the person has been present, may be assessed.
Resident and/or staff records reviewed on (7/9/2021) indicate that all adults who require caregiver background checks have received all required clearances or exemptions.
The Licensee can submit transfer forms to associate new individuals or to disassociate someone from your facility at: Associations_Disassociations858@dss.ca.gov
· The Licensee was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox:UnusualIncidentReportsDO10@dss.ca.gov
· Facility is not currently providing IMS at this time. 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 :

SUPERVISORS NAME: Dawn Parker
LICENSING EVALUATOR NAME: Lakesha Edwards
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: MCCARTHER-MCKNIGHT FAMILY CHILD CARE HOME	FACILITY NUMBER: 334843944
	VISIT DATE: 07/09/2021

NARRATIVE

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There were no deficiencies cited. Application for a Large Family Child Care will be submitted for approval.

During the exit interview, the LICENSEE Chantay McCarther McKnight, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

As a REMINDER: when your child(ren) turn 18 years of age, you MUST SUBMIT an updated LIC279, LIC508 and TB Screen and have your child submit for LIVESCAN background clearance. This also applies to any adult PRIOR to them moving into the home or who currently lives in the home. Also, PRIOR to employment of any adult, you must submit the LIC508, TB screening and obtain a background clearance through LIVESCAN.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS.

A Confidential Names List was completed and provided to the applicant.

A copy of this report was provided to the applicant on this date and must be made available to the public upon request for the next 3 years.
Notice of site visit issued.

SUPERVISORS NAME: Dawn Parker
LICENSING EVALUATOR NAME: Lakesha Edwards
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

LIC809 (FAS) - (06/04)

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