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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 344500619
Report Date: 04/25/2023
Date Signed: 04/25/2023 02:37:27 PM

Document Has Been Signed on 04/25/2023 02:37 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:GALATHIE, SHANTEFACILITY NUMBER:
344500619
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
04/25/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Shante GalathieTIME COMPLETED:
03:00 PM
NARRATIVE
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On 04/25/2023, Licensing Program Analyst Katy Maestas (LPA) conducted a Case Management inspection at the Family Childcare Home (FCCH). LPA arrived at the FCCH and was met by Aide Thomas (A1) who was supervising 3 children and 1 infant. LPA disclosed the purpose of the inspection and was granted entrance into the FCCH. Licensee Galathie (L1) arrived at the FCCH shortly after LPA arrival. LPA determined, through accessing Guardian, that all required adults were background cleared and associated to the license. LPA determined that A1 did not have current CPR and First Aide training and observed A1 supervising 3 children and 1 infant alone at the FCCH. As a result, a Type B deficiency was cited on a subsequent 809-D page.
An exit interview was conducted and the report was reviewed with L1. LPA provided Licensee Appeal Rights to L1 .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: 04/25/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2023
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
Document Has Been Signed on 04/25/2023 02:37 PM - It Cannot Be Edited


Created By: Nola Maestas On 04/25/2023 at 02:03 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: GALATHIE, SHANTE
FACILITY NUMBER: 344500619

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/25/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/02/2023
Section Cited
HSC
1596.866(1)(b)

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...day care home shall ensure that at least one person who has a current certificate in pediatric first aid and pediatric cardiopulmonary resuscitation shall be available at all times when children are present at the facility, or when children are off-site of the facility for facility activities....
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L1 will write and sign a statement aknowledging that she will not leave day care children alone with individuals who are not background cleared AND CPR and First Aide Certified. L1 will enroll 1 Aide into EMSA certified CPR and First Aid Training. L1 will email the statment and proof of enrollment
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Based on observation and record review, Licensee did not ensure that the Aide who was solely supervising an infant and 3 children on 04/25/2023 had current CPR and First Aide Training, which poses a potential Health, Safety or Personal
Rights risk to children in care.
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to LPA by 05/02/2023.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Jeanne Smith
LICENSING EVALUATOR NAME:Nola Maestas
LICENSING EVALUATOR SIGNATURE:
DATE: 04/25/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/25/2023


LIC809 (FAS) - (06/04)
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