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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 015700223
Report Date: 07/28/2021
Date Signed: 07/28/2021 09:57:40 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:DALE, LINDSEYFACILITY NUMBER:
015700223
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
07/28/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lindsey DaleTIME COMPLETED:
10:00 AM
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On 7/28/2021 Licensing Program Analyst (LPA) Jaylena Miller met with licensee Lindsey Dale for an unannounced CASE MANAGEMENT inspection for an INCREASE OF CAPACITY to a large family childcare home. Present for the inspection were licensees fingerprint cleared husband, two teachers, and 5 daycare children were present for the inspection.

The fire clearance for the increase of capacity was received and approved on 7/23/2021.

LPA toured the entire home and backyard for a health and safety inspection. The home has an acceptable amount of space, number of toys and furnishings that are neat, clean and age appropriate. The home is equipped with a fully charged 2A-10BC fire extinguisher, working smoke detector, and working carbon monoxide detector. There is a working telephone in the home. Per licensee there are no firearms on the premises. There are no pools, hot tubs, or other bodies of water at the home. All poisons, cleaning solutions and medications are inaccessible to children. Licensee has current CPR and First Aid training which expires 7/15/2023, Mandatory reporter training was conducted on 8/25/2019 and Lead Poisoning Prevention training was completed on 01/26/2021. LPA Miller reminded licensee that CPR/First Aid and Mandatory Reporter training must be renewed every two years. Per the fire clearance inspection, the garage is off limits to children, LPA Miller reminded licensee and confirmed the garage would not be used as mentioned per the fire clearance.

This home is recommended for a large family home license as of 7/28/2021. There are no deficiencies cited. This report shall remain on file for 3 years. Exit interview conducted with Licensee and a copy of report provided.

SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Jaylena MillerTELEPHONE: (510) 292-8297
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2021
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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