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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 12:33:59 PM

Document Has Been Signed on 10/07/2021 12:33 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:
11:00 AM
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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.

On today's date LPA observed 8 children present, 2 of which were infants and 6 toddlers. LPA discussed with licensee ratio and capacity regulations for a Small and Large Family Child Care Home. Present at 11 a.m. was licensee's adult assistant.

An exit interview was conducted. The following Title 22 Deficiency is being cited on the subsequent 809-D page. Upon receipt of Type A citations, licensee shall post and provide copies of the LIC 809-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Licensee must also keep the signed LIC 9224, acknowledging receipt of LIC 809-D in each child's file. Once the Type A citation is cleared, the facility may be granted a Large Family Child Care Home license. Appeal Rights and Notice of Site Visit were provided. 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
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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Document Has Been Signed on 10/07/2021 12:33 PM - It Cannot Be Edited


Created By: Fabiola Diaz On 10/07/2021 at 11:43 AM
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
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: EALY-HALE, ANGELA
FACILITY NUMBER: 393623106

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/08/2021
Section Cited
CCR
102416.5

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1597.44 ...A small family day care home may provide care for... up to eight children...: (a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age. This requirement was not met as
evidenced by:
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On 10/7/21 during the inspection LPA cleared the Type A citation. Licensee stated that as of today she will meet all ratio and capacity Title 22 regulations. Licensee had an assistant present today to assist with the day care children.
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Based on observation and interview, licensee did not ensure to maintain the ratio specified on the license. LPA observed the licensee in the facility with 2 infatns and 6 toddlers in care.
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LPA provided licensee with printed information regarding ratios and capacity for both small and large Family Child Care Homes. Licensee stated she understands Title 22 regulations regarding ratios and capacity and will contact our Department if she has any questions before enrolling children.

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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:Jeanne Smith
LICENSING EVALUATOR NAME:Fabiola Diaz
LICENSING EVALUATOR SIGNATURE:
DATE: 10/07/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/07/2021


LIC809 (FAS) - (06/04)
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