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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393600152
Report Date: 06/20/2019
Date Signed: 06/20/2019 12:49:59 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:LANG, JANETFACILITY NUMBER:
393600152
ADMINISTRATOR:LANG, JANETFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 470-5264
CITY:STOCKTONSTATE: CAZIP CODE:
95212
CAPACITY:14CENSUS: 7DATE:
06/20/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Janet LangTIME COMPLETED:
01:00 PM
NARRATIVE
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LPA Baney met with licensee for the purpose of an annual inspection. All individuals subject to criminal background review have obtained a criminal record clearance. A health and safety evaluation was conducted in all areas accessible to children. Adequate supervision was observed. Off-limits areas include: Master bedroom, Front bedroom, both garages, side yard and both sheds. LPA observed a working phone, 2A10BC fire extinguisher, first aid kit and functioning smoke and carbon monoxide detectors. Per Licensee, there are no weapons in the home. No children were observed in parked cars. Toxic and hazardous items are inaccessible to children. Safe toys and comfortable accommodations were observed. The fireplace is gas and is appropriately barricaded to prevent access by children. Outdoor play space is fenced and supervised when is use. Medication was appropriately stored an inaccessible to children.

Licensee does provide Incidental Medical Services (IMS) at this time. For IMS information, licensee was advised to see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.
A sample of staff and children's records were reviewed. Required postings, a disaster drill log and proof of mandated reporter training and immunization's were observed. Current pediatric CPR and first aid certification was verified and expires 8/19.
LPA advised the licensee on Safe Sleep Practices and SIDS; the licensee stated they are understood. She stated she uses cribs for sleeping infants and understand infants cannot sleep in car seats, swings or other items not intended for sleeping. 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. Resource and Referral information link was provided to 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. LPA provided the Licensing Agency website (www.ccld.ca.gov), so the licensee may obtain updated licensing information, regulations, and forms. A copy of this report will remain on file for a period of 3 years for public review upon request. In the areas that were evaluated, no deficiencies were cited. Notice of Site Visit was posted.

SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Charlotte BaneyTELEPHONE: (916) 216-7791
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2019
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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