065407539-10-20-2021-13-CC-LCHZ-C7YRFA-20211020125848

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 065407539
Report Date: 10/20/2021
Date Signed: 10/20/2021 12:59:00 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME:	CALLAHAN, JENNIFER FAMILY CHILD CARE HOME		FACILITY NUMBER:	065407539
ADMINISTRATOR:	CALLAHAN, JENNIFER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 330-7615
CITY:	ARBUCKLE	STATE: CA	ZIP CODE:	95912
CAPACITY:	14	CENSUS: 5	DATE:	10/20/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Jennifer Callahan		TIME COMPLETED:	01:05 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/20/2021 at 12:20pm, Licensing Program Analyst (LPA) Laura Chavez conducted an Annual Random inspection. The facility file was reviewed prior to this visit. A review of the Facility Personnel Report Summary dated 10/19/2021 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances. Currently two adults and one minor reside in the home. The home and grounds were toured, and the licensee and her assistant were operating within the licensed capacity. No children were observed in parked cars. The licensee's days and hours of operation are Monday-Friday, 7:30am-5:30pm. There is a working telephone in the home. The floor & yard plan were verified. The home is clean and orderly, with ventilation for safety and comfort. LPA observed toys, play equipment and materials available for children to be safe. The fire extinguisher, smoke detector and carbon monoxide detector in the home meet the standards required. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are stored and inaccessible to children. There is a working smoke detector, carbon monoxide detector and a fully charged fire extinguisher in the home. The firearms and or other dangerous weapons in the home are locked as required. The gas fireplace located in the living-room has been professionally disconnected as well as a plate cover placed over the switch. The applicant understands that the fireplace shall be screened as required should it be used when children are in care. Poisons are locked in the garage. Seven children’s records were reviewed at 12:40pm, each contained emergency identification information as required. The licensee understands that any child showing signs of illness shall be separated from other children. The licensee has completed the Mandated Reporter Training as required. The licensee's CPR and First Aid expire 7/2023. The licensee's immunization's are on file. Report Continued: See LIC809-C

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021

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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: CALLAHAN, JENNIFER FAMILY CHILD CARE HOME	FACILITY NUMBER: 065407539
	VISIT DATE: 10/20/2021

NARRATIVE

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The backyard is divided in half. Children use the fenced in back yard located immediately outside the sliding glass door as their outdoor play area. There is a small duck pond located on the other half of the yard. The duck pond enclosure meets pool fencing requirements. This report was reviewed and discussed with the Licensee. All licensing reports are public information and must be made available upon request for at least three years.

Notice of Site Visit shall be posted for 30 days from today's visit.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Laura Chavez	TELEPHONE: (530) 895-5914
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021

LIC809 (FAS) - (06/04)

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