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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 280107763
Report Date: 07/25/2022
Date Signed: 07/25/2022 11:22:51 AM


Document Has Been Signed on 07/25/2022 11:22 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:WILLIAMSON, CELESTE FAMILY CHILD CARE HOMEFACILITY NUMBER:
280107763
ADMINISTRATOR:WILLIAMSON, CELESTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 963-4649
CITY:ST. HELENASTATE: CAZIP CODE:
94574
CAPACITY:14CENSUS: 9DATE:
07/25/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Celeste Williamson, LicenseeTIME COMPLETED:
11:40 AM
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An annual required inspection was made to the facility by Licensing Program Analyst (LPA), Kevin O'Connell.
A review of staff records on 7/25/2022 indicates that all other facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. 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. There are currently one adult living in the home.
During today’s inspection the home and grounds were toured.
The licensee and her assistant were supervising nine preschool children. The facility’s operating hours are 07:45am to 03:00pm, Monday–Friday. The floor plan submitted by the licensee was reviewed and verified.
The off-limits areas of the home were made inaccessible by door handle covers.
The garage is detached, is off limits and was inaccessible with a door handle key lock. The backyard is used for outdoor play and is completely fenced.
The home was observed to be clean and orderly, and was at a comfortable indoor temperature. There were safe toys and equipment available for children. There is a working telephone in the home.
The licensee’s & assistants Pediatric CPR and First Aid certifications were current. Items which could pose a danger to children (such as detergents, cleaning compounds, medications, etc.) were observed to be stored out of the reach of children.
The licensee stated there are no firearms or ammunition stored on the premises and none were observed. The LPA observed a working smoke detector & carbon monoxide detector and fire extinguisher, rated at least 2A10BC in the home. There is no fireplace.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:
DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2022
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: WILLIAMSON, CELESTE FAMILY CHILD CARE HOME
FACILITY NUMBER: 280107763
VISIT DATE: 07/25/2022
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Poisons are key locked in the detached garage. The Licensee states that there are no pools, spas, fountains or water features and none were observed.
Nine child's records was reviewed at 09:50am during today's inspection.
Two staff records was reviewed at 10:30am.
LPA reviewed infant safe sleep regulations with the 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.

Incidental Medical Services (IMS) policy was discussed. Licensee is not providing any IMS at this time. 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: http://www.ada.gov/childqanda.htm

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Sandra Lider. No title 22 regulations were cited today.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2022
LIC809 (FAS) - (06/04)
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