344500476-8-19-2021-53-CC-ASIA-C62TNQ-20210819145308

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 344500476
Report Date: 08/19/2021
Date Signed: 08/19/2021 02:53:12 PM

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:	LANKENAU, PEGGY & MICHAEL		FACILITY NUMBER:	344500476
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	08/19/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Peggy Lankenau		TIME COMPLETED:	03:00 PM

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	Licensing Program Analyst (LPA) Amy Silva met with the Licensee Peggy Lankenau for the purpose of a pre-licensing inspection for a change of location. Licensee was previously licensed under facility #344500226. Licensee and spouse living in the home have a criminal record clearance. Licensee rents the home and plans to provide care for up to eight children at this time. The Licensee understands that consent must be obtained from the landlord prior to providing care to more than 6 children and up to 8 children. A health and safety inspection was conducted inside and out. The two-story home has an unfenced front yard, 4 bedrooms, 2.5 bathrooms, a family room, play room, kitchen, laundry room, fenced backyard, fenced side yards and a garage. The off-limits areas in the home include: Entire upstairs. The fire place in the family room is appropriately screened to prevent access to children. Toxic and hazardous items are inaccessible to children. Functioning smoke and carbon monoxide detector were observed and tested at 1:50 pm. LPA observed a 3A10BC fire extinguisher located in the pantry in the kitchen. Current pediatric CPR and first aid training was verified and will expire 6/17/23. Mandated reporter training certificate was observed and will expire 8/23/22. Licensee stated there are no weapons in the home. There is no pool at the home. No other bodies of water were observed at the home. *Report continued on 809-C*

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

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: LANKENAU, PEGGY & MICHAEL	FACILITY NUMBER: 344500476
	VISIT DATE: 08/19/2021

NARRATIVE

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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.

LPA reviewed with Licensee the handouts “A Child Care Provider’s Guide to Safe Sleep” and “Safe Sleep Regulations,” sleep log and "Lead Poisoning Facts."

As of today 08/19/2021 facility is approved for a Small Family Child Care Home license for a capacity of 6 children with no more than 3 infants, or 4 infants only, or up to 8 children with no more than 2 infants, 1 child in Transitional Kindergarten or above and 1 child at least age 6. Infants are children under the age of 2.

An exit interview was conducted. No Title 22 Deficiencies observed in the areas that were evaluated. LPA reviewed report with the Licensee and provided a copy.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

LIC809 (FAS) - (06/04)

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