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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493003079
Report Date: 05/05/2022
Date Signed: 05/05/2022 01:43:55 PM


Document Has Been Signed on 05/05/2022 01:43 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:FINKE, STACY FAMILY CHILD CARE HOMEFACILITY NUMBER:
493003079
ADMINISTRATOR:FINKE, STACYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 888-3070
CITY:BODEGASTATE: CAZIP CODE:
94922
CAPACITY:14CENSUS: 9DATE:
05/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Stacy FinkeTIME COMPLETED:
12:00 PM
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A required annual inspection of the facility was conducted by Licensing Program Analyst, Jennifer Velasco (LPA), who met with Licensee Stacy Finke (L1). A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. L1 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. During today’s inspection the home and grounds were toured. L1 and one assistant (S2) were supervising nine children under ten years of age and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The facility’s operating hours are 9:00 a.m. - 3:30 p.m., Monday - Friday, year round. The off-limits areas of the home are the master bedroom, the fenced woodshed area, the fenced pastures on three sides of the home, the storage closets in the home, and the barn in the front of the home. These were made inaccessible by use of key locked doors, fencing, and locked gates. The home was observed to be clean and orderly and was at a comfortable indoor temperature. There were safe toys and equipment available for children. There is a working telephone in the home. L1’s pediatric CPR and First Aid certifications are overdue and will be updated 06/2022. Technical violation was generated. Items which could pose a danger to children (such as detergents, cleaning compounds, medications, etc.) were observed to be stored out of the reach of children in a locked cupboard in the inaccessible kitchen of the home. L1 stated and LPA verified that there are no poisons in the home. LPA observed a tributary north of the home outside the fence line. In the event of heavy rains, it may be possible for the tributary to contain large quantities of water; the tributary is barricaded with a fence that meets regulation standards for rendering a body of water inaccessible to children in care. LPA observed a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC. The roster of children in care was reviewed and was current.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:
DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/05/2022
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: FINKE, STACY FAMILY CHILD CARE HOME
FACILITY NUMBER: 493003079
VISIT DATE: 05/05/2022
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L1 has conducted an emergency drill within the past six months; the last drill was documented in 02/2022. L1 stated there are no firearms or other dangerous weapons in the home, and none were observed during this inspection. Children use the fully fenced, partially shaded yard as an outdoor play space. Five children's records were reviewed at 10:00 a.m., and files contained current immunizations and/or medical exemptions, as well as Parents' Rights Notifications, as required. Facility files were reviewed and complete. Though L1 stated she does not provide care to infants, LPA and L1 discussed the safe sleep regulations and the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed L1 of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. 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 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. Exit interview conducted and report was reviewed with L1. There were no Title 22 deficiencies cited during today's inspection. To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov . For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing-process
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer VelascoTELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:

DATE: 05/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/05/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2