393614670-10-8-2019-53-CC-SWIS-BGRT3W-20191008142300

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 393614670
Report Date: 10/08/2019
Date Signed: 10/08/2019 02:23:06 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:	TRIGG, KATHLEEN		FACILITY NUMBER:	393614670
ADMINISTRATOR:	TRIGG, KATHLEEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 808-1087
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95215
CAPACITY:	14	CENSUS: 10	DATE:	10/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Kathleen Trigg		TIME COMPLETED:	02:30 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) Stacey Williams met with licensee Kathleen Trigg, for an unannounced random annual inspection. Licensee’s assistant was also present during the inspection. There were ten (10) children present during today’s inspection. Licensee’s hours of operation are Monday- Friday 6:00 AM-6:00PM. All adult residents and staff have criminal record clearances. LPA toured areas of the home accessible to children in care. Off-limit areas include: master bedroom and garage. Licensee acknowledged that children may never enter these off-limit areas. The backyard is fenced, and licensee acknowledges that children may never be left unsupervised in an unfenced area of the yard. There are no bodies of water on the property. LPA observed fire drills are conducted monthly and documented to meet regulation guidelines. LPA reviewed CPR/First Aid certification which expires March 2021. LPA reviewed a random sample children’s files and licensee and assistant's file. Immunization records were reviewed. Required licensing posting requirements were posted. Hazardous items and cleaning supplies were inaccessible to children. Medications are inaccessible to children and located on the top shelf on the kitchen cabinet. 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 Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: TRIGG, KATHLEEN	FACILITY NUMBER: 393614670
	VISIT DATE: 10/08/2019

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
26
27
28
29
30
31
32

LPA discussed the Mandated Reporter Training with licensee. Mandated reporter training certification was reviewed in Licensee’s and her assistant’s file. Licensee understands that mandated reporter training is to be renewed every two years and available at: HTTP://WWW.MANDATEDREPORTERCA.COM

No title 22 deficiencies observed in the areas evaluated during today’s inspection.

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. 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. Appeal rights were discussed and provided to licensee.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2