<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 293617612
Report Date: 11/28/2022
Date Signed: 11/28/2022 02:05:23 PM

Document Has Been Signed on 11/28/2022 02:05 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:FEIGHTNER, DAWN M.FACILITY NUMBER:
293617612
ADMINISTRATOR:FEIGHTNER, DAWN M.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 277-6604
CITY:GRASS VALLEYSTATE: CAZIP CODE:
95949
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
11/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Dawn FeightnerTIME COMPLETED:
02:20 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
Licensing Program Analysts (LPA) Matthew Gallo and Karyn Guerra met with the Licensee, Dawn Feightner, for the purpose of an unannounced Annual/Random inspection. The Licensee's assistant was also present upon arrival. All individuals subject to criminal background review have obtained a criminal record clearance. There were 11 children present (2 infants and 9 preschool aged).

Operating hours are 7:30am to 5:30pm, Monday through Thursday. A health and safety inspection was conducted in all areas accessible to children. Off-limits areas include the Master Bed/Bathroom, Laundry Room, Deck, and Garage. Licensee acknowledged that children may never enter these off-limit areas.

LPAs observed a working phone, fire extinguisher, and functioning smoke and carbon monoxide detectors. Licensee noted that there are weapons in the home. Firearms are stored in their own safe and ammunition is separately stored according to Title 22 Regulations. Toxic and hazardous items (detergents, cleaning compounds, medications, sharp utensils, items that could pose a danger to children in care) are properly stored and inaccessible to children.

The fireplace in the home is appropriately barricaded to prevent access by children There are no stairs in the home. Safe toys and play equipment are observed. The outdoor play space is fenced. There are no bodies of water on the premises.

Children’s files were reviewed. A current roster is being maintained. Licensee's fire and disaster drills are conducted and documented. Preventative health training, current pediatric CPR and First Aid certification was verified for the Licensee (expires 2/2024). Mandated Reporter Training (AB 1207) for Licensee was also verified (exp 9/2024)
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2022
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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: FEIGHTNER, DAWN M.
FACILITY NUMBER: 293617612
VISIT DATE: 11/28/2022
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
26
27
28
29
30
31
32
*Continuation of LIC 809

This provider is currently not 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.

LPAs verified the annual fees are current.

LPA provided and discussed the Safe Sleep in Child Care regulations, and licensee understands that a sleep plan needs to be kept for children under 12 months, and 15 minute checks need to be conducted for all infants under 2 years.

LPA reviewed and discussed this facility evaluation report with the Licensee. LPA provided a Notice of Site Visit and the Licensee acknowledges that this notice should remain posted for 30 days for parental review. Licensee was encouraged to visit the Department website at http://ccld.ca.gov for child care updates, current forms, legislation and regulation information.



In the areas that were evaluated, no deficiencies were observed at the time of the visit.

The Licensee's signature on this form acknowledges receipt of this form.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2