Routine inspection (3-year)·July 9, 2025

On 7/09/2025, Licensing Program Analyst (LPA) Ranita Richmond conducted an unannounced visit to the above-named home. The reason for the visit is to conduct the Required 3-year Inspection. LPA was greeted by licensee Cynthia Lang. LPA Richmond observed 9 children, being supervised and cared for by licensee and 1 fingerprint cleared assistant. Hours of operation are Monday through Friday, 7:30am \342\200\2235:30pm. Licensee does not provide overnight and/or weekend care. Licensee provides meals, snacks, and water. LPA Richmond toured the home inside and outside for a Health and Safety inspection. LPA Richmond confirmed that the home is a single story front home. The home consists of three bedrooms, two bathrooms, living room, kitchen, laundry room, and fenced back yard. There is a two story Accessory Dwelling Unit (ADU) on the property in back of the main home. The ADU is off limits to the children in care. The ON LIMIT AREAS are as follows: Bedroom #3, bathroom #2, and fenced back yard. The OFF-LIMIT AREAS are as follows: Kitchen, bedrooms #1 and #2, living room, bathroom #1, laundry room, and ADU. Children and parents enter through side gate, leading to the back of the home. In the back of the home is the rear of the main house and the ADU. Upon entrance of the double patio door you are in bedroom #3. Inside bedroom #3 is bathroom #2. Inside bedroom #3 is a door to the immediate left that leads into the main part of the home which includes bedrooms #1 & #2, kitchen, living room, laundry room, and bathroom #1. Straight ahead in bedroom #3 is a door that leads to the gated back yard. page 1 of 4 Licensee is aware that the children must nap and have meals in the home. LPA Richmond observed a fully charged 2A:10B:C Fire Extinguisher and smoke detector/ carbon monoxide comboin bedroom #3. a There are no firearms or ammunition on the premises. There are no pools, ponds or other bodies of water on the premises. LPA Richmond observed age-appropriate toys, books and furnishings. Furniture and equipment are in good condition, free of sharp, loose, or pointed parts. The licensee currently has three dogs residing in the residence. Codack, a 5 year old German Shepard, is a full time resident in the family daycare home. Lily, a 2 year old tan Lab/Shepard is a full time resident in the family daycare home. Bubs is a 2 year old mini husky who is being fostered until October 2025. Licensee was provided with a Declaration (LIC 855) to complete to indicate the care and accommodations of the dogs during daycare hours. LIC 855 was completed and provided to LPA for file at the Department. Licensee will email current proof of immunizations for dog to LPA for file at the Department. Licensee completed an updated application (LIC 279) to update adults in the home and ages of children served. Application was completed and signed by licensee and provided to LPA to place in file at the Department. LPA reviewed 8 of the children\342\200\231s files and observed them to be complete. LPA provided licensee with infant sleep charts for daily completion for all infants up to 24 months of age. LPA Richmond observed the licensee and assistant has a current 1 st aid/cpr and mandated reporter training completion certificates on file. Per file review LPA observed S02 missing immunizations on file for mmr, tdap, and tb. Type B citation cited. See LIC 809D. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page 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. page 2 of 4 Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm . LPA Richmond reminded Licensee of the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations. 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. Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&R) throughout California. LPA provided applicant with the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children\342\200\231s forms/records, facility forms/records, and information to be posted. LPA Richmond gave applicant a packet of all required forms, and posters and reviewed following forms: CHILDREN'S RECORDS REQUIREMENTS: \302\267 LIC 700 Identification and Emergency Information \302\267 LIC 627 Consent for Emergency Medical Treatment \302\267 LIC 282 Affidavit Regarding Liability Insurance \302\267 LIC 9150 Parent Notification Additional Children in Care \302\267 LIC 9927 Individual Infant Sleeping Plan \302\267 LIC 995A Notification of Parent\342\200\231s Rights \302\267 LIC 613A Personal Rights \302\267 Immunization Record page 3 of 4 FACILITY RECORDS: \302\267 LIC 624B Unusual Incident/Injury Report \302\267 LIC 9040 Child Care Facility Roster \302\267 LIC 9052 Employee Rights, \302\267 LIC 9108 Statement Acknowledging Requirement to Report Child Abuse \302\267 LIC 9149 Property Owner/Landlord Consent Form \302\267 LIC 9151 Property Owner/Landlord Notification Form \302\267 Proof of current pediatric CPR and First Aid Certificates \302\267 Copy of your deed or lease/rental agreement \302\267 Documentation of Fire and Disaster drills \302\267 Proof of immunizations against pertussis (TDAP), measles (MMR), and influenza \302\267 Mandated Reporter certificate \342\200\223 www.mandatedreporterca.com \342\200\223 must be renewed every two (2) years. FORMS TO BE POSTED \302\267 LIC203 Facility License \302\267 LIC 610A Emergency Disaster Plan \302\267 LIC 9148 Earthquake Preparedness Checklist \302\267 PUB394 Notification of Parents Rights Poster In addition, LPA Richmond informed applicant of the following: o There is an effective 24/7 ban on smoking tobacco in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present. o Children and Staff records must be maintained and updated as needed and must be available for review by the Department. o Saucer chairs, bouncers, walkers, or any similar items are prohibited. o All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation. o LPA provided and advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov One (1) Type B deficiency was cited today, per Title 22 Regulations and Health and Safety Codes. See LIC 809D. An exit interview was completed with licensee Cynthia Lang. A copy of report and appeal rights were provided to licensee. Notice of Site Visit provided and required to be posted for 30 days. Page 4 of 4