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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093623154
Report Date: 01/07/2025
Date Signed: 01/07/2025 12:49:15 PM

Document Has Been Signed on 01/07/2025 12:49 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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:EWING, SALLY & DONALDFACILITY NUMBER:
093623154
ADMINISTRATOR/
DIRECTOR:
EWING, SALLY& DONALDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 318-1904
CITY:SOUTH LAKE TAHOESTATE: CAZIP CODE:
96150
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
01/07/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:10 PM
MET WITH:Sally and Donald EwingTIME VISIT/
INSPECTION COMPLETED:
01:10 PM
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On 01/07/2025, Licensing Program Analyst (LPA) Soleil Marx met with Licensees, Sally and Donald Ewing, for an unannounced annual inspection. All individuals subject to criminal background review have obtained a criminal record clearance. During the inspection LPA observed a census of two children in care being supervised by the licensees. Facilities hours of operation are Monday through Friday 07:00 AM to 05:30 PM.

A health and safety inspection was conducted in the areas accessible to children. The off-limits areas include: all bedrooms, hallway closet, laundry room, garage, and front yard. Licensees understands that children may never enter off-limit areas. LPA observed the off-limit areas of the home were inaccessible by child proofing, locked/closed doors, and supervision. LPA observed a working telephone, functioning smoke and carbon monoxide detector, and a fully charged 2A10BC fire extinguisher within the home. LPA observed the home appeared safe and sanitary. LPA observed that hazardous items: detergents, cleaning compounds, medication, sharp utensils, and other items that could pose a danger to children in care, are properly stored out of children's reach. LPA observed a variety of age-appropriate toys, equipment, and materials available to children within the home and fenced backyard. LPA observed gas burning stove within the home is barricaded by baby gate. Licensee stated there are no poisons on the premises. Licensee understands that if there are any poisons in the home, all poisons must be locked with a key lock or combination lock. Licensee stated there are no bodies of water or weapons/firearms on the premises.

LPA observed the facility in compliance with ratio/capacity, supervision, and personal rights regulations. LPA reviewed facility, staff, and children's records. LPA observed all required postings were posted and visible to authorized representatives. LPA observed a complete children's roster maintained and a fire drill log with drills being conducted and documented at least every six months. The last fire drill was conducted 06/2024. LPA reviewed a sample of children’s files and verified files contained the required licensing forms. LPA reviewed records of Licensee files and verified Licensee has current EMSA approved pediatric CPR/First Aid training, which expires 11/2025. LPA verified licensee has current Mandated Reporter Training, which expires 01/2026. Licensee understands both CPR and mandated reporter training's’ must be completed every two years.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/07/2025
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 CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: EWING, SALLY & DONALD
FACILITY NUMBER: 093623154
VISIT DATE: 01/07/2025
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LPA observed safe sleep checks being documented every 15 minutes for all children under the age of two years of age. LPA observed safe sleep practices being followed. LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA 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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

During today’s inspection, LPA determined the facility to be in compliance with Title 22 Regulations. No deficiencies were cited. During the exit interview, the licensees, confirmed that there are no Registered Sex Offenders living in the home and LPA completed the RSO profile in FAS. Exit interview conducted and report was reviewed with the licensees. A notice of site visit was provided and must remain posted for 30 days.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 01/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2025
LIC809 (FAS) - (06/04)
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