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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393610503
Report Date: 12/17/2019
Date Signed: 12/17/2019 02:41:46 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:MELEEN, DEBRAFACILITY NUMBER:
393610503
ADMINISTRATOR:MELEEN, DEBRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 346-5173
CITY:TRACYSTATE: CAZIP CODE:
95376
CAPACITY:14CENSUS: 10DATE:
12/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Debra Meleen TIME COMPLETED:
02:50 PM
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Licensing Program Analyst (LPA) Stacey Williams met with licensee, Debra Meleen for an unannounced random annual inspection. LPA observed (10) ten children present during today’s inspection. Children were supervised by Licensee and her two assistants. Licensee’s hours of operation are Mon-Fri 4:00AM-6:00PM. Criminal record clearances were verified.

LPA toured areas of the home accessible to children in care. Off-limit areas include: all of upstairs, master bedroom closet, and bedroom#4 (to the left). There is an in-ground pool with a 5-foot metal fence surrounding the pool. The pool fence gate opens away from the pool and self-closes and self-latches. There is also a pool covering on the pool. Licensee demonstrated the weight of the pool can withstand an adult by walking across the pool during today’s inspection.

LPA observed fire drills are conducted and documented to meet regulation guidelines. LPA reviewed CPR/First Aid certification which expires August 2021. LPA reviewed a random sample children’s files and licensee and her assistants’ file. Immunization records were reviewed.

Required licensing postings were viewed on a bulletin board in the home. Hazardous items and cleaning supplies were inaccessible to children. Medications are inaccessible to children and located in the closet of the licensee’s bedroom which is off limits. Fire extinguisher and smoke detector meet regulation. Carbon monoxide detector was operable.

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.

Report continues the following page, LIC 809C
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey WilliamsTELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2019
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: MELEEN, DEBRA
FACILITY NUMBER: 393610503
VISIT DATE: 12/17/2019
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LPA discussed the Mandated Reporter Training with licensee. Verification of training was in licensee and her assistant’s file. Licensee understands that mandated training is to be renewed every two years and available at: HTTP://WWW.MANDATEDREPORTERCA.COM

There were no title 22 deficiencies observed in the areas evaluated during today’s inspection.

This facility evaluation report was reviewed and discussed with the licensee. Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for child care updates, current forms, legislation and regulation information. The implementation of AB 2370, lead exposure in Family Child Care Homes and proposed safe sleep regulations was discussed. A copy of this report will remain on file for a period of 3 years for public review upon request. A notice of site visit was provided and should remain posted for 30 days for parental review. Appeal rights were discussed and provided to licensee.
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey WilliamsTELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:

DATE: 12/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2019
LIC809 (FAS) - (06/04)
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