344500421-6-17-2021-53-CC-JBIK-C43M4C-20210617091632

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 344500421
Report Date: 06/17/2021
Date Signed: 06/17/2021 09:16:42 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:	FLUTY, BRENDA		FACILITY NUMBER:	344500421
ADMINISTRATOR:	FLUTY, BRENDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 327-8742
CITY:	GALT	STATE: CA	ZIP CODE:	95632
CAPACITY:	14	CENSUS: 0	DATE:	06/17/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	07:57 AM
MET WITH:	Brenda Fluty		TIME COMPLETED:	09:25 AM

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 6/17/2021 at 7:57 AM Licensing Program Analyst (LPA) Jeevun Birk-Miller conducted an on site pre-licensing inspection due to a change of location and met with Applicant, Brenda Fluty. The applicant was previously licensed and the license number is 343621946. All individuals subject to criminal background review have obtained a criminal record clearance. The were no children in care at this time. A health and safety inspection was conducted inside and out. The one story home has three bedrooms, two and a half bathrooms, a living room, front room, kitchen, dinning room, laundry room, shed and fenced backyard. The off-limit areas in the home are: master bedroom/bathroom and shed. Off-limits areas will remain inaccessible to children by closed doors and/or supervision. The applicant acknowledges that she must contact LPA prior to making an off-limits area on-limits and vice versa. Toxic and hazardous items are inaccessible to children. Functioning smoke detectors were observed in the home. The applicant will be purchasing a carbon monoxide detector and sending the LPA proof of purchase LPA observed a 2-A-10-BC fire extinguisher and a fire alarm pull system. The facility received a fire clearance for a large family childcare from the Consumnes Community Services Fire Department on 06/03/2021. The applicants Pediatric CPR & First Aid expired 5/2021 and the applicant is enrolled in a course so that she can recertify. The applicant had previously taken the Preventative Health and Safety training and is also enrolled in the Lead Poising course to meet the requirements. The applicant stated there are fire arms and the LPA observed them to meet Title 22 Regulation. There is an in ground pool with fencing that meets Title 22 Regulation. Applicant was encouraged to maintain supervision at all times. LPA provided information about Type A/B citations and civil penalties. Report continued on 809-C...

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Jeevun Birk	TELEPHONE: (916) 917-6078
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021

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, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: FLUTY, BRENDA	FACILITY NUMBER: 344500421
	VISIT DATE: 06/17/2021

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed as a reminder. 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 the applicant. LIC 311D, records, postings, and reporting requirements were discussed. LPA discussed supervision, personal rights, criminal record clearances, staffing ratios and capacity, and maintaining buildings and grounds. Applicant was encouraged to visit the Department's website at WWW.CCLD.CA.GOV for information regarding child care updates, forms, regulations and legislation pertaining to family child care homes.

Prior to issuing a license, the following items must be corrected and proof sent to LPA Birk-Miller:

1. Carbon Monoxide Detector purchased and installed. Proof will be sent via photo and video of being tested.

Once the above has been received the LPA will issue a Provisional License for a Large Family Childcare Home due to training's needing to be complete and proof of completion being sent to the LPA.

An exit interview was conducted. A copy of this report was given to the Applicant to keep on file at the facility.

SUPERVISOR'S NAME: Jeanne Smith	TELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Jeevun Birk	TELEPHONE: (916) 917-6078
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021

LIC809 (FAS) - (06/04)

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