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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 393621915
Report Date: 07/01/2021
Date Signed: 07/01/2021 02:32:45 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:MACIAS, MOLLYFACILITY NUMBER:
393621915
ADMINISTRATOR:MACIAS, MOLLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 405-4792
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:14CENSUS: 5DATE:
07/01/2021
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Molly MaciasTIME COMPLETED:
02:45 PM
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On Thursday July 01, 2021 at 12:50 p.m. Licensing Program Analyst (LPA) Elvira Sierra met with Licensee, Molly Macias for an unannounced annual inspection. Upon arrival present in the facility was Licensee caring for her 5 grandchildren, no daycare children were present. Licensee stated she is closed for care until 07/7/21. Facility hours of operation are: Monday-Saturday from 06:00 a.m to 10:00 p.m. Licensee was advised that any new residents must be fingerprint before residing in the home.

At 01:30 p.m. a health and safety inspection was conducted in all areas accessible to children and the following was observed; Off-limits areas are: Master Bedroom, closets on the hallway and garage. Licensee is requesting to make the backyard and bedroom # 2 off limits on today's inspection. Licensee understands that children may never enter these off-limits areas. The facility appeared orderly and suitable for children. LPA observed the required postings, a working telephone, 2A10BC fire extinguisher and functioning smoke and carbon monoxide detectors. A variety of toys and learning equipment available to the children. Licensee stated there are no weapons in the home. Home has a pool that is in compliance with regulations. Medications, toxic and hazardous items are inaccessible to children. The fireplace in the home is appropriately barricaded to prevent access by children. Licensee does not have any daycare children enroll at the moment. Per Licensee she has an appointment to renew her CPR Saturday, 07/03/21 and will email a copy of the new CPR to LPA. Mandated Reporter Training will be renew and a copy will me mail to LPA before facility reopen in July 07,2021.

Report continues on subsuquent page 809C---
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021
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: MACIAS, MOLLY
FACILITY NUMBER: 393621915
VISIT DATE: 07/01/2021
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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 discussed annual fees with Licensee. 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. LPA provided and discussed the Safe Sleep in Child Care and Effects of Lead Exposure brochures.

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.CDSS.CA.GOV for child care updates, current forms, legislation and regulation information. A copy of this report will remain on file for a period of three years for public review upon request. This report and Notice of Site Visit was provided to Licensee.



In the areas that were evaluated, no deficiencies were cited on today's inspection.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2021
LIC809 (FAS) - (06/04)
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