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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503608362
Report Date: 02/08/2022
Date Signed: 02/08/2022 01:28:53 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:DOTY, TANYAFACILITY NUMBER:
503608362
ADMINISTRATOR:DOTY, TANYAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 531-7226
CITY:MODESTOSTATE: CAZIP CODE:
95355
CAPACITY:14CENSUS: 6DATE:
02/08/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Licensee Tanya DotyTIME COMPLETED:
01:30 PM
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On 02/08/2022, Licensing Program Analyst (LPA) Angelica Mejia, conducted a Licensee initiated case management tele-inspection. Due to COVID-19, LPA conducted a tele-inspection with Licensee Tanya Doty via FaceTime. The purpose of today's tele-inspection was to inspect an above ground spa that Licensee recently installed in her backyard. Licensee stated six children were present at the facility today and were napping during the inspection. Licensee stated the spa will be used for Licensee's personal use only and will be off-limits for day care children and during day care operating hours. The spa is square, approximately six and a half feet by six and a half feet, and has a regulation approved locking spa cover. Licensee will provide LPA with an updated Facility Sketch (LIC 999) of the accessible backyard which includes the new spa.

LPA observed the spa cover to be fitted on the spa and strapped down to the base with clips on each corner. All four of the clips were observed to be locked and can only be opened with a key. Licensee attempted to lift the spa cover up while locked and was unable to do so. LPA did not observe any gaps or openings between the spa cover and spa rim while Licensee attempted to lift the locked cover all the way around. Licensee stated the cover is heavy duty and can support the full weight of an adult. Licensee understands the spa cover must be in place and locked at all times when not in use and the steps to the spa must be removed when daycare children are present so that the spa is inaccessible to children. LPA observed the steps to the spa were located behind the regulation approved pool fence in the backyard when not in use. The spa’s mechanical equipment is self-contained and located behind a panel underneath the spa. The panel is secured with screws that must be removed to allow access to the mechanical equipment. LPA inspected and approved the spa and locking cover.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited. An exit interview was conducted with Licensee and a copy of this report and appeal rights were provided via email. Licensee will send a copy of the report signed with her original signature to the Fresno Regional Office.
SUPERVISOR'S NAME: Duane MatsubaraTELEPHONE: (559) 650-7855
LICENSING EVALUATOR NAME: Angelica MejiaTELEPHONE: (559) 341-6126
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2022
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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