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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422660
Report Date: 09/27/2021
Date Signed: 09/27/2021 10:33:04 AM

Document Has Been Signed on 09/27/2021 10:33 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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CATO, SHANNONFACILITY NUMBER:
013422660
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 1DATE:
09/27/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Cato Shannon TIME COMPLETED:
11:00 AM
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On 09/27/2021, Licensing Program Analyst (LPA) Brittany Newton conducted an unannounced visit for the purpose of processing a increase in capacity. LPA was met by licensee Shannon Cato. Present for the inspection was one preschool child and the licensee's fingerprint cleared mother.
The home is a two story which is neat and clean with heating and ventilation for safety and comfort. The home consists of the living room, dining room, kitchen, three bedrooms and a bathroom. The licensee operates Monday through Friday 7:00am to 5:00pm. The off limit areas are the kitchen, entire upstairs, backyard, and all three of the bedrooms. The off limit areas are inaccessible by closed and/or locked doors and visual supervision. The on limit areas are the living room, dining room, and the bathroom. The isolation area is the dining room. Licensee takes the children to the neighborhood park for play. There are ample age appropriate toys that are safe and appear to be clean and in good repair. There are no pools, hot tubs or any other bodies of water. LPA did not observe any hazardous materials or toxins accessible to children today. The licensee provides snacks for children including fresh fruit.

The home has a fully charged 3A40BC fire extinguisher. LPA has reviewed fire clearance which is approved by the local fire department for the facility. The licensee tested the carbon monoxide detector which was found operable. Licensee has a telephone and fully stocked First Aid Kit. The last fire drill was 06/23/2021. Licensee’s CPR and First Aid certificates are current expiring 03/02/2023. The heater vents and fireplace are blocked to prevent access by children. Per applicant, there are no firearms in the home.

Incidental Medical Services (IMS) policy was discussed. 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.
Licensee has implemented best practices during check in and check out process of children due to COVID-19. This includes hand sanitizing stations, required posted flyers limiting visitors and licensee is wearing a mask while providing care.

A copy of the child care roster will be emailed to LPA Newton.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Brittany Newton
LICENSING EVALUATOR SIGNATURE: DATE: 09/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/27/2021
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
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: CATO, SHANNON
FACILITY NUMBER: 013422660
VISIT DATE: 09/27/2021
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The licensee was reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. The applicant was reminded of the responsibility as a mandated reporter.



No deficiencies observed at this visit. The licensee is now approved for a increase in capacity to operate as a large family day care home. A Notice of Site visit was given and licensee was reminded that it is required to be posted for 30 days.

Exit interview conducted and appeal rights provided, and a copy of this report was left with Shannon Cato.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Brittany Newton
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021
LIC809 (FAS) - (06/04)
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