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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 313605310
Report Date: 10/11/2019
Date Signed: 10/11/2019 10:39:57 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:HALL, MARYFACILITY NUMBER:
313605310
ADMINISTRATOR:HALL, MARYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 645-1171
CITY:LINCOLNSTATE: CAZIP CODE:
95648
CAPACITY:14CENSUS: 4DATE:
10/11/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Mary HallTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPAs) Amanda Blesi and Katrina Owens met with the Licensee, Mary Hall, for the purpose of an unannounced Annual inspection. The Licensee's assistant, Marlana arrived later during the inspection. Licensee operates the day care out of the detached mother in law suite adjacent to the main home. All individuals subject to criminal background review have obtained a criminal record clearance. Today's census was 4 children over age two.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the main house and upstairs unit in the mother in law suite and garage. Licensee acknowledged that children may never enter these off-limit areas. LPA observed a working phone, fire extinguisher, and functioning smoke and carbon monoxide detectors.

Licensee stated there are no weapons in the home. Toxic and hazardous items (detergents, cleaning compounds, medications, sharp utensils, items that could pose a danger to children in care) are properly stored and inaccessible to children. No fireplace was observed. There are no stairs in the home. Safe toys and play equipment are observed. The outdoor play space is fenced. The backyard is fenced and gated. There is an above ground pool that licensee uses during the summer. LPA observed the pool was in storage and was not set up today. No bodies of water were observed.

Some children’s files were reviewed. A current roster is being maintained. Licensee fire and disaster drills are conducted and documented. CPR and first aid training were verified to be current and expire 9/2020. Mandated Reporter Training (AB 1207) for Licensee/Assistant was also verified.

This provider is currently 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.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
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: HALL, MARY
FACILITY NUMBER: 313605310
VISIT DATE: 10/11/2019
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LPA verified the annual fees are current. LPA provided the Child Care Advocates Program email address: childcareadvocatesprogram@dss.ca.gov, so the Licensee can request to be added to the distribution list to receive Quarterly Updates.

LPA provided and discussed the Lead Testing brochure (AB 2370) and updated Blue Immunization Cards (CDPH 286)



LPA reviewed and discussed this facility evaluation report with the Licensee. LPA provided a Notice of Site Visit and the Licensee acknowledges that this notice should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at http://ccld.ca.gov for child care updates, current forms, legislation and regulation information.

Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiencies are cited during today's inspection.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2019
LIC809 (FAS) - (06/04)
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