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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 093624769
Report Date: 02/22/2023
Date Signed: 02/22/2023 10:13:41 AM

Document Has Been Signed on 02/22/2023 10:13 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
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME:DUELL, REBECCA/ NICKFACILITY NUMBER:
093624769
ADMINISTRATOR:DUELL, REBECCA/ NICKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 304-6906
CITY:POLLOCK PINESSTATE: CAZIP CODE:
95726
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/22/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Rebecca and Nick DuellTIME COMPLETED:
10:40 AM
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This is a Change of Location from previous facility number 03362258
Licensing Program Analyst (LPA) Soleil Marx, conducted a Change of Location inspection and met with applicants Rebecca and Nick Duell. LPA conducted a health and safety inspection of applicants home. Facility hours of operation will be Monday through Friday, 7:30 AM – 05:30 PM.

This is a three-story home. Off limit areas include: entire 3rd floor, 2nd floor master bedroom and bath, 2nd floor laundry room, garage, shed. Applicant stated she understands that children may not enter off limits areas and any changes made must be cleared through Licensing. Chemicals, knives, medications, and hazardous items are all stored in a way that is inaccessible to children. LPA advised that poisonous items must be key or combination locked. LPA observed the smoke and carbon monoxide detector are functioning properly. LPA observed a 2A-10-BC fire extinguisher. This facility has a current fire clearance for this home. Applicant stores firearms and ammunition in the garage in separate locked safes. There are no bodies of water at the home.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

Applicants submitted proof of current CPR/First Aid, which expires 09/2024. Applicant submitted proof of completed Mandated Reporter training (AB 1207) which expires 06/2023 for Rebecca and 02/2025 for Nick. Applicant understands both CPR and MRT must be renewed every two years.

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE: DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: DUELL, REBECCA/ NICK
FACILITY NUMBER: 093624769
VISIT DATE: 02/22/2023
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Care Licensing Safe Sleep web page can be found at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

Incidental Medical Services- IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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



LPA discussed current COVID guidelines with applicant and provided technical assistance. LPA provided the Department’s website WWW.CCLD.CA.GOV, so the applicant can obtain updated licensing information, new regulations and access forms. LPA advised applicant of their responsibility to stay current by reviewing PINs on the website.

Effective today, 02/22/2022, the new facility is licensed to operate as a Large Family Child Care Home license for a capacity of up to 14 children, two (2) of which must be at least 6 years of age and no more than three (3) may be infants; or 12 children, four (4) of which may be infants. Infants are children under the age of 2.
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Soleil Marx
LICENSING EVALUATOR SIGNATURE:

DATE: 02/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023
LIC809 (FAS) - (06/04)
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