394500029-8-16-2021-53-CC-ESIA-C5XSCX-20210816134615

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 394500029
Report Date: 08/16/2021
Date Signed: 08/16/2021 01:46:24 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:	BEAVERS, BARBARA		FACILITY NUMBER:	394500029
ADMINISTRATOR:	BEAVERS, BARBARA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(209) 474-8268
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY:	14	CENSUS: 0	DATE:	08/16/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Barbara Beavers		TIME COMPLETED:	02:00 PM

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On Monday, August 16,2021. Licensing Program Analyst (LPA) Elvira Sierra met with Barbara Beavers, for an unannounced annual inspection. No children were present during today's inspection. Facility hours of operation are: M-F from 07:00 a.m to 06:00 p.m. All adults living and working in the home have criminal record clearances on file with Licensing Office. Licensee stated that no new residents moved into the home since licensure.

At 01:15 p.m. a health and safety inspection was conducted in all areas accessible to children and the following was observed; The off-limit areas in the home are; 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. Licensee understand 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. There are no bodies of water on the premises. Medications, toxic and hazardous items are inaccessible to children. Outdoor play area is fenced for supervision and is free from defects or dangerous conditions.

A random sample of children’s files were reviewed and a copy of the emergency information card was observed in each child's record. Emergency Fire Drill was last conducted on 06/2021. . LPA observed a current children’s roster and proof.

CPR and First Aid certification was verified and expires on 05/15/2023.Mandated Reporter Training expires on 05/11/23.

Report continues on subsequent page 809C---

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

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: BEAVERS, BARBARA	FACILITY NUMBER: 394500029
	VISIT DATE: 08/16/2021

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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

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. This report and a a Notice of Site Visit was provided. Notice of Site Visit 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.

In the areas that were evaluated, no deficiencies were cited on today's inspection.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

LIC809 (FAS) - (06/04)

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