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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408577
Report Date: 02/23/2024
Date Signed: 02/23/2024 11:44:44 AM


Document Has Been Signed on 02/23/2024 11:44 AM - 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:GAUT, CESYLIFACILITY NUMBER:
073408577
ADMINISTRATOR:GAUT, CESYLIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 451-4088
CITY:CONCORDSTATE: CAZIP CODE:
94521
CAPACITY:14CENSUS: 8DATE:
02/23/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Cesyli GautTIME COMPLETED:
12:00 PM
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On 02/23/2024 at 09:10 AM Licensing Program Analyst's (LPA's) C. Watts and D. Campos conducted an unannounced 3 Year Required inspection at Cesyli Gaut Family Childcare Home. LPA's met with licensee and explained the purpose of today's inspection. LPA's were granted the inspection authority to enter the Home. The family childcare home days and hours of operation are Monday to Friday 08:00 AM to 02:30 PM. Present in the home at time of inspection were licensee, her fingerprint cleared mother who assists with the day care, fingerprint cleared spouse, and 8 school age children in care.

Indoor Space: A health and safety tour of inside the home was done. LPA's toured the premises with licensee. The home is a one story house consisting of 3 bedrooms, 2 bathrooms, living room, kitchen, dining area, office, laundry room. The home is sanitized and orderly in compliance with Title 22 Regulations during today's inspection, with heating and ventilation for the safety and comfort of children in care.


Outdoor Space: LPA's toured the outdoor area side and backyard and observed it was fenced. LPA observed there are no pools, hot tubs or other bodies of water.
OFF-LIMIT areas are the 2 bedrooms and master bathroom, laundry room, the office, and the kitchen. These areas are inaccessible to children in care by closed locked doors and visual supervision. IN-USE The living room, dining room, hallway bathroom, room adjacent to dining room, side and backyard is used as the primary areas for day-care. Medicines, cleaning products, and sharp objects are stored inaccessible to children in care during today's inspection. The home maintains a working telephone. Licensee was reminded that smoking is not allowed in a family child care home. Licensee was reminded that baby walkers, bouncers, jumpers and similar items are not allowed in family childcare homes. Licensee states that there are several pets in the home including chickens, guinea pigs and one dog. Licensee stated there are NO arms and ammunition stored in the home. There is a 3A40BC fire extinguisher, smoke and carbon monoxide detector in the home. Children files and Facility files were reviewed. Facility contained a Children's Roster, Licensee’s mandated reporter training expires 08/2024.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana CamposTELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2024
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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: GAUT, CESYLI
FACILITY NUMBER: 073408577
VISIT DATE: 02/23/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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

See LIC809D for deficiency cited today.

Exit interview conducted and report was reviewed with the licensee Cesyli Gaut and assistant Cindy Bruno.

SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana CamposTELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:

DATE: 02/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 02/23/2024 11:44 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612


FACILITY NAME: GAUT, CESYLI
FACILITY NUMBER: 073408577

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/23/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(a)(6)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information: (6) Documentation of completion of training on preventative health practices as required by Section 102416(c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that a copy of the CPR certificate was not available for review today which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/22/2024
Plan of Correction
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Licensee shall submit a copy of current CPR/first aid certificate or proof of registration to renew CPR certificate to LPA by the POC date of 3/22/24
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana CamposTELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2024
LIC809 (FAS) - (06/04)
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