573607438-8-31-2021-53-CC-CHUR-C6ER6K-20210831124453

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 573607438
Report Date: 08/31/2021
Date Signed: 08/31/2021 12:45:01 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:	GEE, DOROTHEA & CABALTERA, ELIZA		FACILITY NUMBER:	573607438
ADMINISTRATOR:	GEE,DOROTHEA&CABALTERA,ELI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 662-5667
CITY:	WOODLAND	STATE: CA	ZIP CODE:	95695
CAPACITY:	14	CENSUS: 2	DATE:	08/31/2021
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Licensees, Dorothea Gee & Eliza Cabaltera		TIME COMPLETED:	01:00 PM

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 August 31, 2021, Licensing Program Analysts (LPAs) Chayntel Hunter and Christopher Jackson met with Licensees, Dorothea Gee and Eliza Cabaltera for the purpose of an unannounced annual inspection. All individuals subject to criminal background review have obtained a criminal record clearance. There were two children present at the time of inspection. Licensees' operating hours are Monday through Sunday from 4:45 AM to 12:30 AM. A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include: master bedroom, son's bedroom, office, laundry room and the garage. Off limit areas are being made inaccessible by closed locked doors and baby gates. LPAs observed the required postings and a working phone. 2A10BC Fire extinguisher meets regulations. LPAs observed smoke and carbon monoxide detectors, and verified they were both functional. LPAs toured the kitchen area and verified knives and cleaners were inaccessible to children in care. LPAs observed living room area with age appropriate toys for children. LPAs observed a fireplace that was blocked by a couch. LPAs observed a restroom and verified that hazardous and toxic items were inaccessible to children in care. Licensee stated there are weapons in the home. LPAs verified that weapons and ammunition were stored in separate locked safes. There are no bodies of water on the premises. Outdoor play space is fenced. The play equipment appears to be in good repair. LPAs observed a locked shed on the left side of the backyard. LPAs observed the additional shed on the right side of the backyard. The back side yards are blocked by a gate. LPA verified the annual fees are current. Report continues on 809-C.

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021

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: GEE, DOROTHEA & CABALTERA, ELIZA	FACILITY NUMBER: 573607438
	VISIT DATE: 08/31/2021

NARRATIVE

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In addition, LPAs discussed the infant sleep regulations with licensees. LPAs discussed the requirement to check and log infant napping every 15 minutes for infants 24 months and under. LPAs provided a copy of LIC 9227 Individual Sleeping Plan, for infants under 12 months, for licensee during today's inspection.

Children's files were reviewed. Emergency information and required immunization records were on file. LPAs observed a current roster and documentation that a fire drill is conducted at least once every six months. Licensee's immunization records for measles (MMR), pertussis (Tdap), and the flu are available in the facility file. Current in-person EMSA pediatric CPR and First Aid certification was verified and expires 05/2023 and Child Care Provider Mandated Reporter certification was verified and expires 02/2022.

LPAs reviewed new COVID19 self-assessment guide and conducted a technical assistance tour of the facility to incorporate Department of Public Health safety protocols for operating during the pandemic. LPAs discussed posting requirements and facility operations including sanitation and pick up/drop off procedures.

This provider is not currently providing IMS services to children in care. 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.

This facility evaluation report was reviewed and discussed with Licensees. A Notice of Site Visit was provided and should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at WWW.CCLD.CA.GOV for childcare updates, current forms, legislation and regulation information. Licensee's signature on this form acknowledges receipt of this form.

In the areas that were evaluated, no deficiencies were cited during today’s inspection.

SUPERVISOR'S NAME: Justin L Denton	TELEPHONE: (916) -92-0269
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021

LIC809 (FAS) - (06/04)

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