<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500029
Report Date: 06/18/2021
Date Signed: 06/18/2021 10:45:20 AM

Document Has Been Signed on 06/18/2021 10:45 AM - It Cannot Be Edited

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:BEAVERS, BARBARAFACILITY NUMBER:
394500029
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/18/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Barbara BeaversTIME COMPLETED:
11:00 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
On Friday, June 18, 2021, at 09:30 a.m., Licensing Program Analyst (LPA) Elvira Sierra conducted an unannounced increase of capacity inspection and met with Licensee, Barbara Beavers. Facility operates M-F from 07:00 a.m. to 06:00 p.m. No children were present during the inspection. Fire Safety Inspection Clearance was granted on 06/16/21 for a total capacity of 14 children. All individuals residing in the home have obtained a criminal record clearance.

At 09:45 a.m. a health and safety inspection was conducted inside and out. This facility is a single story home with 4 bedrooms and 3 bathrooms. The off-limit areas in the home will consist of; Bedrooms #2, #3 and # 4, bathroom # 3 inside master bedroom and bathroom # 1 next to bedroom # 4, laundry room and left and right side of the backyard that is fenced. Bedroom #4 is a converted garage. Both bedroom #4 and the bathroom next to bedroom #4 are barricaded by gate. Fire extinguisher, smoke and carbon monoxide detectors meet regulation. Sharp knives, toxins and cleaning supplies are inaccessible to the children. Toys appear to be safe and appropriate for children in care. Licensee stated that there are no weapons in the home and no bodies of water. The facility currently does not provide Incidental Medical Services – IMS. LPA discussed IMS services and the requirement to create a plan of operation. Specifics on the plan can be found in the family childcare home evaluator manual (FCCH EM) Policy 102417. A current CPR/First Aid was verified and expired on 05/15/2023. Mandated Reporter Training was verified and expires on 05/11/2023. LPA reviewed large family childcare home capacity limitations with licensee. Safe Sleep in Child Care, the Effects of Lead Exposure brochures, COVID-19 Posting documents and the use of Personal Protective Equipment during COVID-19 Outbreak guidance were observed in the home.

As of today's date, facility is licensed to serve 12 children (when there is an assistant present) with no more than 4 infants, or capacity of 14 children when 1 child is enrolled in Transitional Kindergarten or elementary school and 1 child at least age 6 with a maximum of 3 infants. No deficiencies were observed in today's inspection. This report (LIC 809) and a Notice of Site Visit was provided. Notice of Site Visit should be posted in a conspicuous area for 30 days .

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE: DATE: 06/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/18/2021
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 1