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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500515
Report Date: 10/24/2024
Date Signed: 05/28/2025 11:22:46 AM

Document Has Been Signed on 05/28/2025 11:22 AM - 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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:GILLUM, DENISHAFACILITY NUMBER:
394500515
ADMINISTRATOR/
DIRECTOR:		GILLUM, DENISHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 955-9942
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 7DATE:
10/24/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Denisha GillumTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 10/24/24, Licensing Program Analyst (LPA) Elvira Sierra met with the Licensee, Denisha Gillum for the purpose of an unannounced annual inspection. Two licensee's assistants were also present during the inspection. Facility hours of operation are 7 days a week 24 hours a day. Applicant understands not to exceed 24 hours of consecutive care. A review of the Facility Personnel Summary shows that all adults living and working in the home have criminal record clearances on file with Licensing Office. The licensee stated that no new residents moved into the home since licensure. Entrance Checklist for Family Childcare Homes was provided to Licensee. Census include seven children, including licensee’ child. Capacity specified on the license was met on today’s inspection.

A health and safety inspection was conducted in all areas accessible to children. Off limit areas are: Bedroom # 2 or master bedroom, bathroom # 2, (inside master bedroom), bedroom #1, and garage. Upon entry, LPA observed the posting of the facility license, Emergency Disaster Plan, Earthquake Preparedness Checklist and Notification of Parent Rights. Home is clean and appropriately ventilated. Facility maintains a working phone, 2A10BC fire extinguisher, and functioning dual smoke/carbon monoxide detectors. Age-appropriate toys and reading material were observed. Per licensee there are no weapon in the home. Toxic and hazardous items are inaccessible to children. The fireplace in the home is appropriately barricaded to prevent access by children. No bodies of water were observed on the premises. Outdoor area is fenced for supervision. Licensee was reminded to notify LPA of any changes on her hours of operation of changes to her off limits areas or vice versa. Licensee provide meals and transportation for clients if needed.

LPA reviewed five children's files. LPA observed all required forms for the children in care are complete and maintained in the file. Current in person EMSA CPR and First Aid certification was verified and expires 10/21/25 and AB 1207 Mandated Reporter Training was verified and expires on 09/24/25. LPA observed a current roster and fire drills are conducted at least once every six months and are properly log.

Report continues on subsequent page 809C--

NAME OF LICENSING PROGRAM MANAGER: Bettina Engelman
NAME OF LICENSING PROGRAM ANALYST: Elvira Sierra
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2024
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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: GILLUM, DENISHA
FACILITY NUMBER: 394500515
VISIT DATE: 10/24/2024
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All individuals subject to criminal background review have obtained a criminal record clearance. Licensee was reminded that all adults 18 and over living or working in the home, 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 Family Child Care Home. 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.
Licensee acknowledges that a Plan for Providing IMS must be submitted to the Department if provided. 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. Licensee states she will not administer medication. 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.
Licensee was made aware of the (LIC9227) Individual Infant Sleeping Plan, for infants under 12 months and sleep logs for all infants in care under 24 months need to be maintained in children’s files. LPA discussed and provided an example of a sleep log and the safe sleep regulations with Licensee and provided 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. Licensee states she will not enroll infants.
LPA also informed Licensee, 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 they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA encouraged Licensee to visit the department website at WWW.CCLD.CA.GOV for information regarding childcare updates, forms, regulations and legislation pertaining to family childcare homes.
To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process
Report continued on subsequent 809C...
NAME OF LICENSING PROGRAM MANAGER: Bettina Engelman
NAME OF LICENSING PROGRAM ANALYST: Elvira Sierra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024
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 S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: GILLUM, DENISHA
FACILITY NUMBER: 394500515
VISIT DATE: 10/24/2024
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

LPA verified the annual fees are current. The license explained that absences shall not exceed 20 percent of the hours that the facility is providing care per day. Licensee must notify the department anytime facility is closing for vacation or any other leave that requires to be absence more than 20 percent per day

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 communication platforms. To receive important licensed related information to licensed facilities, 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.



An exit interview was conducted. This report and Appeal of Rights were reviewed and provided to Licensee, Denisha Gillum. Notice of Site Visit posted and should remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Bettina Engelman
NAME OF LICENSING PROGRAM ANALYST: Elvira Sierra
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2024
LIC809 (FAS) - (06/04)
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