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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434416489
Report Date: 10/13/2022
Date Signed: 10/18/2022 02:45:33 PM

Document Has Been Signed on 10/18/2022 02:45 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:HARP, JENNIFERFACILITY NUMBER:
434416489
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
10/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Harp, JenniferTIME COMPLETED:
12:30 PM
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On this day Licensing Program Analysts (LPA/s) Almaraz conducted an unannounced inspection. The purpose of this visit for an increase of capacity and conduct an annual random inspection. Licensee currently operates a small family childcare home (capacity 8) and would like to increase to a large family childcare home (capacity 14).

Due to COVID- 19 precautionary measures were taken, licensing staff present during inspection wore appropriate personal protective equipment. LPA/s met with Licensee, Harp, Jennifer and explained the nature of today's inspection. Present during the inspection was the licensee. Licensee states that there is currently 1 child/ren enrolled in the small Family Child Home Day Care. There were two children present, including licensees child. The hours of operation of the day-care are 7AM to 6 PM, Monday through Friday. There are 2 adults residing in the home (criminal record clearances on file). Licensee and brother Harp, Kyle and four minor children.

Physical Plant: This is house dwelling which consists of 4 bedrooms and two lavatories. LPA/s inspected the indoor and outdoor areas of the home today. Per licensee off limit areas in the home are as follows, Master bedroom, bathroom, laundry room inside of the garage. Off limit areas outside the home are as follows: The dog area, separated with a gate and back area, also fenced. The backyard is fully fenced. The front yard is safety complaint. The children use the back yard for activities.

During this inspection, the following was noted: At 9:30 AM, LPA/s began tour through the interior of the home. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and central heating for safety and comfort. 1/4
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HARP, JENNIFER
FACILITY NUMBER: 434416489
VISIT DATE: 10/13/2022
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There were safe toys, play equipment and materials observed for children. LPA/s did not observe any hazards inside of the home. There is a working telephone service maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The licensee states that there are no poisons in the home. The licensee does understand that poisons must be locked with a key or combination lock. Licensee states that there are no weapons in the home. LPA did not observe any bodies of water inside or outside the home. Licensee has 3 pet/s, vaccinated.

LPA/s discussed the sleeping equipment for infants. LPA/s explained that there must be cribs for each infant who is unable to climb out of the play yard. All equipment must meet the US Consumer Product Safety Commission safety standards. Please see www.safekid.org for a list of any recalled products. LPA/s explained that cribs must be free from loose articles and objects. There must be no objects hanging above or attached to the side of the cribs. LPAs explained that play yards must not hinder the entrance or exit to and from the space they are sleeping in. Mattresses must be firm and covered with a fitted sheet that is appropriate to the mattress size. Each infant must have their individual bedding and washed weekly as required. Soiled bedding must be replaced when wet or soiled and placed in an area inaccessible to infants. Pacifiers must not be attached to anything. Licensee was advised that infants shall not be swaddled while in care and all infants up to 12 months should be placed on their back for sleeping. LPA went over regulation 102425 with licensee.

Facility Records: Licensee a has the following: 1. CPR and First Aid, valid thru 08/07/23 2. MMR & Tdap vaccinations, as well as opt out for flu vaccine. 3. A current roster. 4. There is currently no homeowner’s insurance. 5. Mandated Reporter Training, valid for thru 07/27/23, licensee understands this must be renewed every two years.

LPA/s issued the Children’s Record Review (LIC 857) and the Review of Staff records (LIC 859) to the Licensee during this inspection. LPA/s reviewed 1 children's file and observed current and updated immunization records and the Family Child Care Home Notification of Parents' Rights forms (LIC 995A) in each file. LPA advised licensee to have a complete file for own child, LPA observed current immunization's for child 2/4
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022
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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HARP, JENNIFER
FACILITY NUMBER: 434416489
VISIT DATE: 10/13/2022
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Incidental Medical Services (IMS) policy was discussed. Per Licensee there are currently no children enrolled who required IMS. 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

LIC 9227 (Individual Sleeping Plan) for infants up to 12 months was discussed. Title 22 Regulation Section 102425(j) Infant Safe Sleep was discussed with the Licensee, including but not limited to documentation that shall be maintained. A review of PIN 20-24-CCP Recently approved Safe Sleep Regulations in Effect was discuss and a copy was provided to the Licensee during this inspection.

Fire and Disaster Safety: LPA/s observed a working smoke/carbon monoxide detector, 2A40BC fire extinguisher, both checked by the fire department 09/02/22. LPA did not observe any heaters in the home. LPA Almaraz observed a screened fireplace. Fire disaster/earthquake drills last log 08/10/22.

Supervision: Supervision of the children was observed; Licensee understands the following: A cleared adult must be present in the home during day care hours. The children must be supervised at all times. The capacity options and ratio requirements. Licensee understands not to leave children in the car unattended. The Licensee states that there may be transporting of children. LPA discussed placing safety knobs on masterbedroom and first bedroom to the left in hallway for best practice. Also discussed was a lock for cabinet in bathroom so licensee can store hair products. SB792 (Immunization Requirements for Staff and Employees) was discussed with the Licensee. The following was discussed:
· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearance prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty. 3/4
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022
LIC809 (FAS) - (06/04)
Page: 3 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: HARP, JENNIFER
FACILITY NUMBER: 434416489
VISIT DATE: 10/13/2022
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· The Licensee shall be present in the home and shall ensure that children are supervised at all times.
· Children shall not be left in park vehicles.
· The capacity specified on the license shall be the maximum number of children for whom care can be provided.
· Car seats shall only be used for transportation purposes and shall not be used for sleeping.
· All children in care have the right to receive safe, healthful, and comfortable accommodations, furnishings and equipment.
· When a child shows signs of illness, they will be separated from other children until the nature if the illness is determined.
· Personal rights must be accorded to the children in care.
· Reporting requirements.

LPA reviewed and issued the LIC 311 - Forms/Records to Keep in Your Family Child Care Home.
CHILDREN’S FORMS/RECORDS, FACILITY FORMS/RECORDS and INFORMATION TO BE POSTED, Disaster drills, posting requirements, children’s records requirements, mandated child abuse and injury/death reporting, and criminal record transfer requirements were discussed. LPA observed all required postings.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

At this time, there were no deficiencies cited during today’s inspection.

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

Exit interview conducted and report was reviewed with facility representative,



LPA advised that the increase of capacity is pending Management approval
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SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Araceli Almaraz
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4