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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483000566
Report Date: 01/11/2024
Date Signed: 01/11/2024 01:31:37 PM


Document Has Been Signed on 01/11/2024 01:31 PM - 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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405



FACILITY NAME:GALILEO, SANDRA FAMILY CHILD CARE HOMEFACILITY NUMBER:
483000566
ADMINISTRATOR:GALILEO, SANDRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 446-6916
CITY:VACAVILLESTATE: CAZIP CODE:
95687
CAPACITY:14CENSUS: 6DATE:
01/11/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Sandra Galileo - LicenseeTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA), Melchisedeck Augustin made an unannounced Plan of Correction (POC) visit and met with Licensee (LS), Sandra Galileo to follow up on an outstanding type A deficiency that was cited on 01/05/24. Furthermore, on 01/05/24, the facility was cited seven type B deficiencies for not ensuring an above pool in the backyard was accessible and met fencing requirements, not notifying the Department of the installation of the above ground pool, not having a functional carbon monoxide detector, did not furnish AB 1207 Mandated Reporter Training certificates for LS and S1, not furnishing a current EMSA approved pediatric CPR/First Aid certification, not furnishing required staff Immunization Records (IR); children's records were missing IR; and children's IR were not transcribed onto the blue CDPH 286. The POC for the type B deficiencies are due by 01/15/24 and 01/19/24.

During today's visit, LPA observed six children in the care of LS and S1. The report which cited a type A deficiency was posted on the front entry door and there was a functional carbon monoxide detector installed. LS allowed LPA to take a tour of the off limit bedroom and office. The bedroom sliding glass door and office window that led to the pool yard had sensors which were connected to a panel located near the entry door which alerted LS and staff if the windows were to be opened. The bedroom and office doors were closed and key locked. Furthermore, LPA observed an existing latch on the wooden gate that fenced the pool and LS installed an additional latch on the outside of the gate. LPA reminded LS that the aboveground pool was required to meet fencing requirements. LS stated she intends to request a waiver and she would produce and immediately submit a request for a waiver. LPA reviewed eight children's records which contained LIC 9224 that were signed by the children's parent.

LS submitted in-service receipt for the installation of the sensors, AB 1207 Mandated Reporter Training certificate for LS and EMSA approved pediatric CPR/First Aid certification which expire on 02/15/24. LPA applied the POCs that LS submitted to clear several deficiencies, and LPA generated and provided LS with POC clearance letters. (Continue to LIC 809-C)
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck AugustinTELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:
DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/11/2024
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: GALILEO, SANDRA FAMILY CHILD CARE HOME
FACILITY NUMBER: 483000566
VISIT DATE: 01/11/2024
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Exit interview conducted and report was reviewed with the Licensee, Sandra Galileo. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. The were no violation(s) of the California Code of Regulations, Title 22; Division 12, observed during today’s visit.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Melchisedeck AugustinTELEPHONE: (707) 494-4918
LICENSING EVALUATOR SIGNATURE:

DATE: 01/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024
LIC809 (FAS) - (06/04)
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