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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013423286
Report Date: 11/15/2022
Date Signed: 11/15/2022 10:25:38 AM

Document Has Been Signed on 11/15/2022 10:25 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 STE 1102
OAKLAND, CA 94612
FACILITY NAME:DALLAS, CALETHAFACILITY NUMBER:
013423286
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
11/15/2022
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Caletha DallasTIME COMPLETED:
10:36 AM
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Licensing Program Analyst Sidney Cortez, met with licensee Caletha Dallas for an UNANNOUNCED ANNUAL RANDOM INSPECTION. Present for this visit was the licensee, her fingerprint cleared assistant Camoni Randloph and 3 pre school age children. The home was toured to conduct a Health and Safety Inspection. The facility currently operates from 8:30AM until 4:30 PM, MONDAY-FRIDAY.
The home is a two story house which is neat and clean with heating and ventilation for the safety and comfort of the children. The OFF LIMIT AREAS are the garage, the right side area of the backyard, the shed in the backyard and the entire second floor of the home. The off limit areas will be blocked by gate, safety handles and or visual supervision. The ON LIMIT AREAS are the living room, the dinning, the kitchen, the downstairs half bathroom and portion of the backyard. The ISOLATION AREA will be in the living room on the smaller couch.
There are no pools, hot tubs or any other bodies of water on the premises. All hazardous materials and toxins are kept out of the reach of children.The home has a fully charged 2A10BC fire extinguisher, working smoke detector, working carbon monoxide detector, working telephone. The Licensee’s Health and Safety training is completed and CPR and First Aid certificates are current and expire Oct 2023. The applicant is in compliance with new immunization laws which pertain to day care providers. Per applicant, there are no firearms in the home. A copy of the mortgage statement was reviewed and shows control of property.The licensee's mandated reporter training is current and expires (Nov 2023). Per licensee, there are no firearms in the home. The licensee conducts and documents fire and disaster drills twice a year with the last one conducted on June, 2022. 2 Children files were reviewed, facility roster reviewed and copy obtained. The licensee is in ratio today. All REQUIRED forms are posted and visible for public review. See 809 C for Continuation
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2022
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: DALLAS, CALETHA
FACILITY NUMBER: 013423286
VISIT DATE: 11/15/2022
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Licensee is 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. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov.

LPA Cortez provided a copy of Safe Sleep-in child care brochure, a handout "What Does A Safe Sleep Environment Look Like," and a copy of the new California Car Seat Law Changes. The licensee was provided information regarding effects of Lead Exposure and testing requirements (Assembly Bill 2370).

This report shall remain on file for 3 years. Exit interview conducted with licensee.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC809 (FAS) - (06/04)
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