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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 343622321
Report Date: 03/28/2023
Date Signed: 03/28/2023 12:45:00 PM

Document Has Been Signed on 03/28/2023 12:45 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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:BAGGS, AUDREYFACILITY NUMBER:
343622321
ADMINISTRATOR:BAGGS, AUDREYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 228-4865
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
03/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Audrey BaggsTIME COMPLETED:
01:00 PM
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On 03/28/2023, Licensing Program Analyst Katy Maestas (LPA) conducted a field visit to the Family Childcare Home (FCCH) for the purpose of an unannounced annual inspection. LPA arrived at the FCCH and was met by Licensee Audrey Baggs (L1). LPA disclosed the purpose of the inspection and was granted entrance into the FCCH. LPA observed 5 preschool aged children being supervised by 1 adult. LPA accessed Guardian to determine that all required adults were background cleared. L1 stated there are no new residents in the home since licensure. LPA toured the areas of the FCCH that are accessible to children in care. L1 accompanied LPA for the entirety of the tour. The OFF-limits areas of the FCCH include the office, laundry room, entire 2nd floor, garage and side yard. L1 acknowledged that children may never enter these OFF-limits areas. L1 reports her hours of operation to be Monday through Friday from 8:30 am until 11:30 am. L1 stated that she does not provide overnight or weekend care.

LPA conducted a file review before arrival at the FCCH. LPA provided the Entrance Checklist to L1. LPA discussed the required postings in a FCCH with L1 and ensured that postings are current. LPA reviewed the children’s files for those who were in attendance. LPA reviewed the adult’s files and immunizations. LPA observed a current Facility Roster and observed the Fire Drill log to ensure that drills are conducted at least once every 6 months. A functioning smoke detector and carbon monoxide detector was observed in the hallway and tested. LPA observed cleaners stored in kitchen cabinets that are behind doors with child safety locks. LPA observed medications stored in cabinets that are behind doors with child safety locks. LPA observed knives stored in kitchen drawers that have child safety locks. The fireplace in the living room was observed to have a glass barricade; however, L1 stated that the fireplace is not used during operational hours. LPA observed a baby-gate barricading the stairway to make the stairs inaccessible to children. LPA observed a 2A10BC fire extinguisher in the play room that appeared to be in the green zone. Toys appear to be safe and in good supply. LPA did not observe any pool, spa nor water feature.

Continued on 809-C

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE: DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/17/2023
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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: BAGGS, AUDREY
FACILITY NUMBER: 343622321
VISIT DATE: 03/28/2023
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LPA observed the backyard and surrounding fence through a window. Due to rain, LPA was unable to walk the backyard. L1 stated that the fence is stable and was recently repaired. LPA observed several play structures in the back yard that appeared to be in working condition and are cushioned by grass. L1 stated there are no weapons in the home. L1 stated that she has 1 dog and 3 cats.

LPA discussed Mandated Reporter Training with the L1. Health and Safety Code 1596.8662 requires that all licensed providers, applicants, directors, and employees complete training as specified on their mandated reporter duties and renew their training every 2 years. Volunteers are encouraged but not required to take the training. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. The OCAP modules are free of cost and available at http://www.mandatedreporterca.com/. The training is currently provided in English and Spanish. L1 has a current Mandated Reporter Training Certificate which will expire on 03/24/2024. Current Pediatric CPR and First Aid training was also verified by LPA and expires on 08/07/2023.

LPA discussed the Safe Sleep Regulations with L1 and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed L1 of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended that s/he register all infant devices with the CPSC to be notified of any recalls on purchased equipment.

Licensee does not currently provide Incidental Medical Services (IMS); however, the IMS policy was discussed with L1, and she was encouraged to create an IMS plan to provide epipen services. For IMS information, see PIN 22-02-CCP. 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information through this communication platform. Continued on LIC 809-C

SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
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
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: BAGGS, AUDREY
FACILITY NUMBER: 343622321
VISIT DATE: 03/28/2023
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To receive licensed related information, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

L1 was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, PRIOR to initial presence in a licensed FCCH. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

L1 understands that licenses are not transferable, and once licensed, licensee must live in the home and be present for 80% of the operating hours. L1 understands that if an unusual incident occurs; licensing is to be notified via phone call, e-mail or fax within 24 hours and the Unusual Incident Report/LIC 624 shall be submitted within 7 days to remain in compliance. L1 understands that if any structural changes are made to the home; licensing must be notified PRIOR to construction. L1 understands that if she wants to make any OFF-limits area an ON-limits area, she must notify licensing and LPA must do an inspection BEFORE children are allowed in said area. L1 understands that children’s records are to be maintained according to Title 22 regulations and be accessible to licensing for up to 3 years.



If you have any questions regarding this inspection process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding this inspection and its tools and methods, please visit at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.


NO Title 22 Deficiencies were observed in the areas that were evaluated today on 03/28/2023. An exit interview was conducted, and the report was reviewed with L1. LPA provided L1 with Licensee Appeal Rights. A Notice of Site visit was posted by LPA and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jeanne Smith
LICENSING EVALUATOR NAME: Nola Maestas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023
LIC809 (FAS) - (06/04)
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