393606299-2-4-2020-53-CC-GSIH-BLGPQN-20200204103124

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393606299
Report Date: 02/04/2020
Date Signed: 02/04/2020 10:31:28 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:	FIELDS, DENISE		FACILITY NUMBER:	393606299
ADMINISTRATOR:	FIELDS, DENISE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 472-9319
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY:	14	CENSUS: 4	DATE:	02/04/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Denise Fields & Joe Fields		TIME COMPLETED:	10:40 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	Licensing Program Analyst (LPA) Singh met with licensee, Denise Fields, and her husband, Joe Fields, for an annual random inspection. The purpose of the inspection was explained. Licensee lives in a single story home. Present, there are four children (two infants, two pre school age) in care. All adults living or working in the home have criminal background check on file. Licensee is operating within the capacity of this date. Licensee provides day care from Monday to Friday as needed. LPA inspected the day care areas with the licensee. Day Care Areas: Family room, Living room, Bedroom # 1, Kitchen, Dining area and Backyard. Off limit areas: Bedroom # 2, Master Bedroom and Garage. There is no pool, spa or any other body of water in the house. As per licensee, there is no firearm or weapon in the house. All the cleaning supplies, poisons and other chemicals are stored inaccessible to the children. LPA observed the knives being stored on high shelf in the kitchen. Fireplace is barricaded. The house is in good repair and free of hazards with proper temperature and ventilation. There is carbon monoxide detector, smoke detector, fully charged fire extinguisher and working telephone available in the house. There is a variety of age appropriate toys in the house. At 10 AM, LPA review the facility records. LPA observed facility has all of the required documents posted and visible for the public. LPA reviewed the identification and emergency information form for every child for proper names and numbers filled. Licensee has record of training of preventive health and CPR card valid until March 2020. LPA remind the licensee to conduct the fire or emergency drills at least once every six months and drills must be logged. Licensee has a log in place. Per log, last drill was conducted in September 2019. Licensee’s and her husband’s immunization records were previously provided to the department. See next page for continuation ...........

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

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: FIELDS, DENISE	FACILITY NUMBER: 393606299
	VISIT DATE: 02/04/2020

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Licensee is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on file. Per certificate, the training was completed on August 05, 2018.

LPA discussed the safe sleep regulation concepts and effects of lead exposure. LPA also provided the handouts to the licensee. LPA encourage the licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

LIC809 (FAS) - (06/04)

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