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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 173010163
Report Date: 02/11/2022
Date Signed: 02/11/2022 12:53:44 PM

Document Has Been Signed on 02/11/2022 12:53 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
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:WICHLAZ, HEATHER FCCHFACILITY NUMBER:
173010163
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
02/11/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Heather WichlazTIME COMPLETED:
01:15 PM
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Licensing Program Analyst (LPA) Glenn Ouye met with licensee Heather Wichlaz to conduct a case prelicensing inspection due to a change of location to this new home. A change of location application was received by the department on February 7, 2022.

Hours of operation will be Monday through Friday; 7:30am to 5:30pm. The applicant understands that 24-hour consecutive care is prohibited. The home is a four bedroom/ four bath home. One adult live in the home. Applicant was advised that anyone residing or working at the facility must have a criminal background clearance on file with CCLD. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance. The floor and yard plans are verified. The children will have access to the living room/play room, kitchen, dining area and a hallway bathroom. The outdoor deck has the main entrance to the facility. The large outdoor deck witll be used as the outdoor play area. The deck has railing with fabric outdoor mesh. The bedrooms are on the upper story and in the basement. The upstairs and basement are off limits to the daycare children. Off-limits areas are rendered inaccessible by means of child safety gates. The home appears to be clean and orderly at this time and will remain so during child care hours. There is a working telephone. The sharp knives, cleaning supplies, and medicines, are stored out of the reach of children. The applicant states there are two guns in the home which are locked in a safe and ammunition is stored separately in locked containers. Applicant stated no poisons are stored on site. First Aid supplies are kept in the entryway. The children in care will have access to age appropriate toys and equipment. The home is equipped with a working smoke detector, carbon monoxide detector. The fire extinguisher rated at least 2A10BC was discharged at the time of the visit. The licensee agrees to obtain a new fire extinguisher and send a photo of the extinguisher and receipt to LPA Ouye.

Continued on LIC 809-C

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE: DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/11/2022
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, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: WICHLAZ, HEATHER FCCH
FACILITY NUMBER: 173010163
VISIT DATE: 02/11/2022
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There is no pool, spa, hot tub or bodies of water . There are two stock tanks that have drainage holes and do not fill with water.

Incidental Medical Services regulations were reviewed with the applicant. The applicant has a Plan of Operation on file with the Department.



Proof of control of property is on file. Parent's rights are posted. Emergency drills must be conducted at least once every six months and the date documented. Children's records to be maintained were reviewed. The roster is to remain current at all times. Unusual Incident Report procedures were explained, to include notification before close of next business day and follow-up with written report within seven days. The applicant will maintain current on Pediatric CPR and First Aid. CPR and First Aid cards expire on March 15, 2022. The licensee has already scheduled her CPR and first aid renewal certification class. The applicant shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current Pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. Infants or children shall not be allowed to sleep in car carriers in the home. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged. Smoking is prohibited at all times in any area where child care is provided. The applicant understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website. http://ccld.ca.gov/ Megan's Law web site was provided (http://www.meganslaw.ca.gov). The licensee understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice. Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

The licensee will be approved upon receipt of proof of purchase of a new fire extinguisher rated at 2A10BC.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Glenn Ouye
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2022
LIC809 (FAS) - (06/04)
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