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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300330
Report Date: 03/25/2022
Date Signed: 03/25/2022 04:20:26 PM

Document Has Been Signed on 03/25/2022 04:20 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:SUGMAD FAMILY CHILD CAREFACILITY NUMBER:
336300330
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 9DATE:
03/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Tiara SugmadTIME COMPLETED:
04:25 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 2022 at 9:10 AM Licensing Program Analyst (LPA) Susan Brewer, arrived unannounced at the facility to conduct an annual inspection. LPA conducted a COVID19 prescreening and was granted entry by Licensee Tiara Sugmad. LPA conducted a census of 9 children in care, 2 which were infants. LPA toured the facility inside and out, reviewed records, and observed and/or discussed the following: Present were the licensee. At 9:49 AM a private rental company arrived for an outside bounce house activity scheduled by licensee for spring break. Licensee Spouse Janny Sugmad arrived at approximately 11:20 AM.

Normal days and hours of operation are Monday- Friday, 6:00 AM – 6:00 PM, Weekends upon Request. OFF-LIMIT AREAS INCLUDE: Entire 2nd Floor, Garage, Den next to the kitchen and Laundry Room.

· The inspection consisted of reviews of the following domain: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio, Capacity and Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. Deficiencies cited this visit.


· The facility is NOT operating within the licensed capacity and appropriate ratios. At At 9:13 AM, LPA S.Brewer, conducted a census of 9 children in care, 2 children in care being infants causing the licensee to operate out of the licensed ratio and capacity. Licensee Tiara Sugmad, stated that spring break for Temecula started last week and normally she does not have the 2 school age children ages 7 & 8, at the facility at the same time as the younger children. The Licensee is present in the home and has ensured that children in care are supervised.
· When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children.
· A working telephone is present.
· Appropriate fire extinguisher, smoke detector and carbon monoxide detector are present and were tested by the Licensee spouse Janny Sugmad during this inspection 03/25/2022.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE: DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/25/2022
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 4
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: SUGMAD FAMILY CHILD CARE
FACILITY NUMBER: 336300330
VISIT DATE: 03/25/2022
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
· All hazardous items are NOT inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children. At 10:31 AM LPA observed steak knives in a lower pull drawer in the kitchen and on kitchen counter. At 10:38 AM LPA observed hygiene products, shaving razors, hair clippers and vicks rub in the shower and restroom cabinets used by the daycare children.
· Storage of poisons is inaccessible to children and locked on 03/25/2021.
· There is a properly barricaded fireplace on 03/25/2022.
· Guns or weapons ARE present as stated by the Licensee Tiara Sugmad. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations.
· Stairs are barricaded at this time on 03/25/2022.
· Home is clean and orderly, with heating and ventilation for safety and comfort
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced and/ or appropriate supervision is present
· Verification of control of property on file 03/25/2022
· Property owner/landlord notification and consent on file and verified.
· Pediatric CPR and First Aid Training complete on 10/05/2021 Online Card expire on 10/05/2023.
· Health & Safety Certificate - completed on 06/08/2017, Lead component completed 02/04/2021.
· Mandated reporter: General: Not on file. Child Care Expires: 08/2020, Licensee failed to renew.
· Documentation of fire & earthquake drills to be conducted every six months: Not completed since licensed on 03/12/2022.
· There ARE bodies of water on 03/25/2022. Licensee Tiara Sugmad 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 was notified at the time of the pre-licensing inspection of the above types of bodies of water on 03/12/2021 which was inspected and cleared on that day. LPA S.Brewer, re-inspected on 03/25/2022 and the facility was in compliance of the Title 22 Regulations. 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.
· Children’s files are NOT complete. LPA conducted review of children's records Child 3 and Child 5 present and in care, did not have Infant Safe Sleep Logs or LIC9227 Sleep Plans, documented, Immunization records missing for Child 1, Child 2, Child 3 and Child 4; LIC627 Medical Consent forms Missing for Child 6 and Child 7, LIC995A Parent Rights forms Missing for Child 3, Child 4 and Child 6.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: SUGMAD FAMILY CHILD CARE
FACILITY NUMBER: 336300330
VISIT DATE: 03/25/2022
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
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.

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: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensee was reminded that all adults 18 and over living or working in the home, 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

See LIC809D for cited deficiencies 2 Type B 102416.5 (b)(3) and 102416.5(c) Staffing Ratio and Capacity.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Tiara.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Susan Brewer
LICENSING EVALUATOR SIGNATURE:

DATE: 03/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 03/25/2022 04:20 PM - It Cannot Be Edited


Created By: Susan Brewer On 03/25/2022 at 02:47 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
, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: SUGMAD FAMILY CHILD CARE
FACILITY NUMBER: 336300330

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.5(b)(3)
Staffing Ratio and Capacity
(b) For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be one of the following: (3) More than six and up to eight children, without an additional adult attendant, only if the criteria in
Section 1597.44 of the Health and Safety Code are met.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA S. Brewer, census taken and observations 9:13 AM Licensing Program Analyst took a census and observed the licensee Tiara Sugmad did not comply with the section cited above by caring for 9 daycare children present, 2 children under years of age, without an assistant which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/28/2022
Plan of Correction
1
2
3
4
The licensee Tiara Sugmad stated that as of today 03/25/2022, all daycare parents will be notified of the limits for licensed capacity of a small family child care home and will only operate within the allowable ratio of children by Title 22 regulations listed above. The licensee agrees to submit a statement of understanding the cited regulation by Monday 03/28/2022, to Community Care Licensing by mail, fax or e-mail.
Type B
Section Cited
CCR
102416.5(c)
Staffing Ratio and Capacity
(c) The total licensed capacity for a Small Family Child Care Home shall not exceed eight children.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on LPA S. Brewer, census taken and observations 9:13 AM Licensing Program Analyst took a census and observed the licensee Tiara Sugmad did not comply with the section cited above by caring for 9 daycare children present, 2 children under years of age, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/28/2022
Plan of Correction
1
2
3
4
The licensee Tiara Sugmad stated that as of today 03/25/2022, all parents will be notified of the limits for licensed capacity of a small family child care home and the licensee will not exceed the licensed capacity of 6-8 children in care. The licensee agrees to submit a written statement of understanding the cited regulation by Monday 03/28/2022, by mail, e-mail or fax to Community Care Licensing.
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:Pauline Beschorner
LICENSING EVALUATOR NAME:Susan Brewer
LICENSING EVALUATOR SIGNATURE:
DATE: 03/25/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2022


LIC809 (FAS) - (06/04)
Page: 4 of 4