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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393623106
Report Date: 10/07/2021
Date Signed: 10/07/2021 12:51:25 PM

Document Has Been Signed on 10/07/2021 12:51 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:EALY-HALE, ANGELAFACILITY NUMBER:
393623106
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
10/07/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Angela Ealy-HaleTIME COMPLETED:
01:00 PM
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On October 7, 2021 Licensing Program Analyst (LPA) Fabiola Diaz met with licensee, Angela Ealy-Hale, for the purpose of an increase of capacity inspection. Licensee applied to change from a Small Family Child Care Home to a Large Family Child Care Home. Upon entering the home, LPA observed 8 day care children and licensee's 4 daughters present in the home. Three of licensee's daughters were available to assist with day care children. Present at 11 a.m. was licensee's adult assistant.

The one story home has a gated front yard, 4 bedrooms, 2 bathrooms, day care room, living room, dining room, kitchen, family room, garage, laundry room, and fenced backyard. The off-limits areas in the home are garage, laundry room, all bedrooms, and left side of backyard. Licensee acknowledged that children may never enter the off-limit areas. Licensee acknowledged that if she would like to change an off-limits area to on-limits, she will inform LPA for inspection and approval prior to using the space. All adult residents have criminal record clearances.

During the inspection, LPA requested a tour of the facility. LPA and Licensee conducted a health and safety tour inside and out the home. Functioning smoke and carbon monoxide detectors and 2A10BC fire extinguisher were observed in the home. The Fire Safety Inspection Clearance has been cleared by Stockton Fire Prevention as of 9/3/2021. The fire place in the family room is barricaded meeting Title 22.

LPA observed that there were no hazardous items accessible to children. Licensee stated that she understands that any poisons must be kept under lock and key. LPA observed that cleaning materials were inaccessible. Licensee stated there are no weapons in the home. Toys appear to be safe. LPA discussed safety regulations of play equipment.



LIC 809 continues on LIC 809C...
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Fabiola Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2021
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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: EALY-HALE, ANGELA
FACILITY NUMBER: 393623106
VISIT DATE: 10/07/2021
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Records, postings and reporting requirements were discussed. LPA discussed maintaining a complete children's roster and children's files. On today's date 10/7/2021 LPA observed the children's files to contain their immunization records, but the records were not transferred to the CDPH- 286 form. Licensee was encouraged to visit the department website at WWW.CDSS.CA.GOV for information regarding child care updates, forms, self-assessment guides, regulations and legislation pertaining to family child care homes. Licensee was provided with the new Safe Sleep Regulations. On today's date LPA provided with current COVID-19 guidance for day cares and COVID-19 postings.

Today 10/7/21, the facility was approved for a Large Family Child Care License to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or above and 1 child at least age 6 with a maximum of 3 infants. Without assistant, the ratios revert to those for small family childcare home.

An exit interview was conducted. The licensee was assessed an Advisory Note. LPA observed the Notice of Site Visit to be posted: it must remain posted for 30 days.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Fabiola Diaz
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC809 (FAS) - (06/04)
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