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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 574500508
Report Date: 02/05/2025
Date Signed: 02/05/2025 01:09:16 PM

Document Has Been Signed on 02/05/2025 01:09 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 SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME:REICHENBACH, REBEKAHFACILITY NUMBER:
574500508
ADMINISTRATOR/
DIRECTOR:		REICHENBACH, REBEKAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 204-0254
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
02/05/2025
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:licensee, Rebekah ReichenbachTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
NARRATIVE
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On February 5, 2025, Licensing Program Analyst (LPA) Lauren Scott conducted an unannounced field visit to the facility. LPA met with licensee, Rebekah Reichenbach.

LPA determined through accessing Guardian and police reports, that one of resident in the home does not have a valid background clearance.

LPA determined by interview and review of records, an Unusual Incident Report was not reported to CCLD within 24 hours, nor was it submitted in writing within 7 days.

One Type A and one Type B violation was assessed on a subsequent 809-D page. The facility shall also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Facility has been provided with appeal rights.



Exit interview conducted and report was reviewed with licensee, Rebekah Reichenbach. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE: DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/05/2025
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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Document Has Been Signed on 02/05/2025 01:09 PM - It Cannot Be Edited


Created By: Lauren Scott On 02/05/2025 at 12:52 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: REICHENBACH, REBEKAH
FACILITY NUMBER: 574500508

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/06/2025
Section Cited
CCR
102370(a)

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all adults residing in the home shall obtain a California criminal record clearance.

This requirement was not met as evidenced by:
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Facility will have resident obtain a proper background clearance and submit proof to LPA by POC date. Or facility will submit proof to LPA of new residence for the resident.
CIVIL PENALTIES ASSESSED
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Based on interviews and record review, one resident of the home did not have a proper background clearance.

This poses an immediate health, safety, or personal rights risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Chayntel Hunter
LICENSING EVALUATOR NAME:Lauren Scott
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/05/2025 01:09 PM - It Cannot Be Edited


Created By: Lauren Scott On 02/05/2025 at 12:56 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: REICHENBACH, REBEKAH
FACILITY NUMBER: 574500508

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/05/2025
Section Cited
CCR
102416.2(b)(3)(C)

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… (3) A report shall be made to the Department…(C) any unusual incident… that threatens the physical or emotional health or safety of any child

This requirement was not as evidenced by:
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Licensee will submit a UIR regarding the incident to LPA by POC date. Licensee agrees to call the officer of the day at CCLD office to inquire if unsure if an event was reportable at 916 263-5744
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LPA did not receive a UIR for the incident that occurred at the facility on 1/7/25 requiring police involvement
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Chayntel Hunter
LICENSING EVALUATOR NAME:Lauren Scott
LICENSING EVALUATOR SIGNATURE:
DATE: 02/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/05/2025


LIC809 (FAS) - (06/04)
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