Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 455406119
Report Date: 03/03/2016
Date Signed 03/03/2016 11:20:36 AM

COMPREHENSIVE INSPECTION
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:MANN, DELLENE FAMILY CHILD CARE HOMEFACILITY NUMBER:
455406119
ADMINISTRATOR:MANN, DELLENEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 440-5966
CITY:REDDINGSTATE: CAZIP CODE:
96003
CAPACITY:14CENSUS: 4DATE:
03/03/2016
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Alice (Marie) KeenTIME COMPLETED:
11:30 AM
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A visit was made to the facility by LPA, Jordan Monath. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are presently 2 adults living in the home. The licensee was not at home during this visit. The licensee's mother was providing care to 4 children.

During today’s visit the home and grounds were toured and the licensee was operating within the licensed capacity. Normal operating hours are 6am to 9pm, Monday – Friday. The floor plan was verified. Off limits areas are inaccessible. The home appeared clean and orderly. There is a working telephone in the home. The licensee has taken a course in Preventive Health Practices. The licensee and her assistant both had current pediatric CPR and First Aid cards. The items that could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. Poisons are locked in an outdoor shed. There is a working smoke detector, carbon monoxide sensor, and fire extinguisher in the home. There was a current roster of children in care. An emergency drill has been conducted within the last six months. The licensee's assistant stated there are no firearms and/or other dangerous weapons in the home and none were observed during today's visit. Children's records were reviewed and in compliance. The children use the backyard as the outdoor play area and it is completely fenced. All licensing reports are public information and must be made available upon request for at least three years.
Notice of Site Visit shall be posted for 30 days from today's visit.

In the areas that were evaluated, no deficiencies were observed at the time of the visit.
SUPERVISOR'S NAME: Lisa McKayTELEPHONE: (530) 895-5033
LICENSING EVALUATOR NAME: Jordan MonathTELEPHONE: (530) 513-1214
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2016
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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