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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500146
Report Date: 05/25/2021
Date Signed: 05/25/2021 03:23:32 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:BALDWIN, MICHELLEFACILITY NUMBER:
574500146
ADMINISTRATOR:BALDWIN, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 383-8664
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY:14CENSUS: 3DATE:
05/25/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Licensee, Michelle BaldwinTIME COMPLETED:
03:30 PM
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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.

On May 25, 2021 LPA Hunter met with Licensee Michelle Baldwin for the purpose of a case management inspection. The purpose of today's televisit is to change the backyard from an off limits to an on limits area. 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. Toxic and hazardous items are inaccessible to children. Outdoor play area is fenced. LPA observed 2 locked sheds in the backyard. As of today 05/25/21 the Backyard will be changed to an on limits areas, accessible to children in care. Off-limits areas include the entire upstairs.

This facility evaluation report was reviewed and discussed with Licensee. A Notice of Site Visit was provided and should remain posted for 30 days for parental review.

In the areas that were evaluated, no deficiencies were cited during today’s inspection.
SUPERVISOR'S NAME: Sharon OgbodoTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:

DATE: 05/25/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021
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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