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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093622615
Report Date: 12/04/2019
Date Signed: 12/04/2019 10:24:14 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:HANAWALT, RENEEFACILITY NUMBER:
093622615
ADMINISTRATOR:HANAWALT, RENEEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 934-4239
CITY:EL DORADO HILLSSTATE: CAZIP CODE:
95762
CAPACITY:14CENSUS: 12DATE:
12/04/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Licensee Hanawalt, ReneeTIME COMPLETED:
10:35 AM
NARRATIVE
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Licensing Program Analysts (LPAs) Michelle Pascual and Seychelle De Luca met with Licensee for an annual/random inspection and capacity increase. LPAs toured areas of the home accessible to the children. Off-limit areas: entire upstairs, gargage, patio, RV access and guest room outside. Licensee acknowledged that children may never enter these off-limit areas. Licensee stated there are no new residents in the home, and all adult residents have criminal record clearances. Upon arrival, today’s census was 12 children and 2 adults.

LPAs observed current CPR/First Aid certificate (exp: 01/21), posted License, Parents' Rights Poster, facility sketches, and Emergency Disaster Plan. LPAs discussed recent changes regarding safe sleep for infants and potential lead testing.
LPAs observed care and supervision of children in care. LPAs observed that all knives were out of reach of children and properly stored. Stairs were properly barricaded and fireplace had a cover. There is a working telephone in the home.
Licensee stated there are no weapons in the home. Fire extinguisher, carbon monoxide, and smoke detector meet regulation. LPAs observed fire drills documented on a calendar. Toys appear to be safe and in working order. The backyard is fenced. LPAs observed the yard to be in compliance and the sandbox/kiddy pool has holes in it to properly drain any water that accumulates.

Report continues on 809-C.

SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019
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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: HANAWALT, RENEE
FACILITY NUMBER: 093622615
VISIT DATE: 12/04/2019
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This provider is currently not providing IMS services to children in care. Incidental Medical Services (IMS) policy was discussed. 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

This facility evaluation report was reviewed and discussed with Licensee.

This facility evaluation report was reviewed and discussed with the licensee. A Notice of Site Visit was provided and should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at WWW.CDSS.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request. The licensee's signature on this form acknowledges receipt of this form.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Michelle PascualTELEPHONE: (916) 704-7665
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019
LIC809 (FAS) - (06/04)
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