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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013422081
Report Date: 07/18/2022
Date Signed: 07/18/2022 05:39:40 PM


Document Has Been Signed on 07/18/2022 05:39 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612



FACILITY NAME:KISLING, CYNTHIAFACILITY NUMBER:
013422081
ADMINISTRATOR:KISLING, CYNTHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 927-0568
CITY:OAKLANDSTATE: CAZIP CODE:
94603
CAPACITY:14CENSUS: 13DATE:
07/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:29 PM
MET WITH:Cynthia KislingTIME COMPLETED:
05:30 PM
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An unannounced Required - 1 Year inspection was conducted by Licensing Program Analyst L. Dyer. LPA arrived at the facility at 1:29 p.m. The licensee was present with 13 day care children (1 infant, 8 preschool-age and 4 school-age), her spouse, her daughter, and her mother, all fingerprint cleared. Facility is in compliance with licensed capacity and facility ratios. Phone number and e-mail address are current. Hours: 7:00 a.m. - 5:30 p.m.
At 1:42 p.m., the following was observed: the day care area of the home was inspected. Areas licensed for child care: bathroom, living room, dining room. Off-limit areas will be made inaccessible to children by closed and/or locked doors; gates; and visual supervision. The home was clean and orderly, with adequate heating and ventilation. There were a variety of books and toys for children's use. There was a working smoke detector (tested); a fully charged 3-A:40-B:C fire extinguisher; a first aid kit, and a carbon monoxide detector. Taking of temperatures was discussed. There were safe, healthful and comfortable accommodations, furnishings and equipment available to children at the time of this inspection. Fireplace was blocked by play equipment. There are no hazardous materials, medicines, or cleaning solutions accessible to children during this inspection. Hazardous items are kept on a high shelf , inaccessible to children. Licensee stated there were no firearms or bodies of water on the premises. Front yard area is securely fenced. Licensee has a riding toys, balls, push toys, slides, and other outdoor toys for child play.

Licensee currently has 1 infant in care over 12 months of age, in which a sleeping plan is not required. LPA, however, discussed the safe sleep regulations with the licensee and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and- resources/safe-sleep as an additional resource. LPA also 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. Also given and discussed: Guidance for Child Care Providers and Programs (version June 29, 2021) and Individual Sleeping Plans. (continued)
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis DyerTELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2022
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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KISLING, CYNTHIA
FACILITY NUMBER: 013422081
VISIT DATE: 07/18/2022
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LPA reviewed facility, children's and personnel records at 3:47 p.m. Licensee's Mandated Reporter Training expires 5/19/23, and CPR/First Aid expires 7/2024. Last disaster drill - 7/7/22. All files are complete and all required postings are visible for public review. Facility roster was current.
Licensee was reminded that all adults 18 and over living or working in the home, 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 maximum per day/per person will be assessed if this regulation is violated. Licensee was also reminded of the Department's Inspection authority, and the need to comply when notified that termination of an employee is necessary. Also discussed with the licensee: supervision of children at all times; children are not to be left in parked vehicles; car seats and high chairs; Unusual Incident Reporting; advertisements; changes in on-limit areas; construction work at facility; smoking; ill children in home, and the Guardian background check process. A qualified assistant must be physically present whenever 9 or more children are in care. When an assistant is not present, the home reverts back to small family child care ratios.
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at: www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Important E-mail Addresses: Community Care Licensing General Information and Updates:www.ccld.ca.gov.
Mandated Reporter Training: www.mandatedreporterca.com.Guardian: background check process with self-service options: https://www.cdss.ca.gov/inforesources/ cdss-programs/community-care-licensing/caregiver-background-check/guardian

NO DEFICIENCIES CITED TODAY.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with licensee Cynthia Kisling.
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Phyllis DyerTELEPHONE: (510) 725-7006
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2022
LIC809 (FAS) - (06/04)
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