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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500146
Report Date: 12/03/2020
Date Signed: 12/03/2020 10:21:51 AM

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:BALDWIN, MICHELLEFACILITY NUMBER:
574500146
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
12/03/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Licensee, Michelle BaldwinTIME COMPLETED:
10:30 AM
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Due to COVID-19 pandemic, Licensing Program Analyst (LPA) Chayntel Hunter is conducting a tele-inspection via FaceTime with the Licensee, Michelle Baldwin. In lieu of Licensee's signature, LPA Hunter is emailing the report with a read receipt request. The purpose of today's inspection is for a change of capacity. Fire clearance has been approved by the Woodland Fire Department on 12/02/2020. Licensee stated there are no new residents in the home since licensure. All individuals subject to criminal background review have obtained a criminal record clearance.

A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the entire upstairs. Licensee is making off limit area inaccessible to children in care by baby gate. There is a fireplace in the home that is appropriately barricaded. Functioning smoke and carbon monoxide detectors were observed in the hallway. LPA observed medications, cleaners, and knives to be stored in an overhead cabinet above the stove, in the kitchen. Fire extinguisher is located in the pantry and a second fire extinguisher is mounted on wall in the kitchen. Licensee stated there are no longer any weapons in the home.
Outdoor play area is fenced. LPA observed a locked shed in the backyard.

During the inspection, LPA did not observe any violation of regulation. No deficiencies are cited today. The report is reviewed and provided to the Licensee. Notice of site visit is posted and shall remain posted for next 30 days.

As of today, Licensee is granted the license for Large family child care home. Facility will be approved for the capacity increase to serve up to either 14 children, two (2) of which must be at least 6 years of age and no more than three (3) may be infants; or 12 children, four (4) of which may be infants. Infants are children under the age of 2.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020
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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