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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500508
Report Date: 10/06/2023
Date Signed: 10/06/2023 10:41:52 AM

Document Has Been Signed on 10/06/2023 10:41 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
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:REICHENBACH, REBEKAHFACILITY NUMBER:
574500508
ADMINISTRATOR:REICHENBACH, REBEKAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 204-0254
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
10/06/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:licensee, Rebekah ReichenbachTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Lauren Scott met with Licensee, Rebekah Reichenbach for the purpose of an unannounced plan of correction inspection to clear a Type B deficiency, which was issued on 8/23/23 for physical plant/ home being unkempt. As well as two type B's that were issued on 9/28/23 for mandated reporter training and 15 minute sleeping checks.

During today's inspection LPA toured all areas accessible to children in care and saw the home to be orderly and non-odorous. LPA also observed Mandated Reporter certificate and 15 minute sleeping logs.

Deficiencies cited on 8/23/23 and 9/28/23 are cleared effective today. Exit interview conducted and report was reviewed with the licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2023
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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