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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 045407684
Report Date: 02/11/2020
Date Signed: 02/11/2020 12:35:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME:BROWN, KIMBERLY FAMILY CHILD CARE HOMEFACILITY NUMBER:
045407684
ADMINISTRATOR:BROWN, KIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 774-3368
CITY:CHICOSTATE: CAZIP CODE:
95928
CAPACITY:14CENSUS: 2DATE:
02/11/2020
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Kimberly BrownTIME COMPLETED:
12:40 PM
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A pre-licensing inspection was conducted by Licensing Program Analyst (LPA) Sandy Husband. The applicant is requesting licensing for a large family child care home with capacity not to exceed 14 with a fingerprint cleared assistant present. Operational hours are 6:30 AM to 6:30 PM, Monday-Friday. The residence is a three bedroom/two bath, single story home with an attached garage and two detached sheds which must be used according to the permit per the fire clearance. There are two adults living in the home. Applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with Community Care Licensing Department. All minors residing in the home must be fingerprinted within 30 days of reaching their 18th birthday and obtain a TB clearance. The applicant is aware of the immediate civil penalty for adults working or residing in the home without a criminal record clearance.
During today's inspection, the applicant was providing exempt care to her own child and one child from another family. The accessible areas of the home are the living room, bedrooms 2 and 3, the kitchen during meals, the children's bathroom, the back porch and back yard. The off limits rooms are the master bedroom, master bathroom, laundry room, the garage and the two outdoor sheds that will remain locked or inaccessible during daycare hours. The applicant was residing in the outdoor shed and per the Fire Marshall may not reside in this location and it must be used according to the permit. These rooms will be made inaccessible via door knob covers and gates. The garage will be locked to make it inaccessible. The back yard is not fully fenced because multiple boards are missing or not secured. The backyard will be the outdoor play area and will have hazards removed or made inaccessible prior to licensing. The applicant understands that 100% supervision is required at all times when the back yard play area is not fully fenced with secured boards. The back yard has children's useable toys and will be free from debris and hazards. Front yard is unfenced and applicant understands that 100% supervision is required at all times when children use the front yard. Parts of the home appeared to be clean and orderly, however the kitchen floor had raised, torn linoleum causing the bare floor to be exposed which created a tripping hazard. This hazard will be repaired prior to licensing. The floor and window sill near the children's eating table also contained debris, food, and cobwebs that will be removed and cleaned prior to licensing, and will remain so during licensed child care hours. There is a working telephone in the home. The sharp
(Continued on LIC 809-C)
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra HusbandTELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020
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, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: BROWN, KIMBERLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 045407684
VISIT DATE: 02/11/2020
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(Continued from LIC 809)
knives, cleaning supplies, and medicines will be stored out of the reach of children. The applicant stated the poisons will be locked in the attached garage. There are no firearms/weapons on the premises and none were observed during today's inspection. The children in care will have access to age appropriate toys and equipment. The home is equipped with at least one working smoke detector, carbon monoxide detector and a charged fire extinguisher. The applicant has not decided if liability insurance will be provided for the children. Parents' rights will be posted. Emergency drills must be conducted at least once every six months and the date must be documented. The applicant shall be present in the home and shall ensure that children in care are supervised by a fingerprint cleared adult with current Pediatric CPR and First Aid certification. The applicant's CPR/1st Aid certification expires on 1/26/22. The applicant understood that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. The applicant understood the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) allowed were discussed; when caring for over 12 children, one of the children in care must be school-aged and one must be at least 6 years of age. Smoking is prohibited in the home at all times and in outdoor areas where children are present. Incidental Medical Services (IMS) will not be provided and IMS policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. 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. Safe sleep practices and the Information flyer regarding lead requirements were discussed with the applicant. The applicant understood the responsibility to read and have knowledge of the laws and regulations for the 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 at http://www.meganslaw.ca.gov. The applicant understood that any authorized employee of the Department may enter and inspect the facility with or without advance notice. This report was reviewed and discussed with the applicant. All licensing reports are public information and must be made available upon request for at least three years.
Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.
Notice of Site Visit shall be posted for 30 days from today's inspection
Prior to licensing the following is required and shall be submitted to CCLD:

1. All poisons will be locked in the attached garage.
2. Sharp items such as knives will be inaccessible.
3. All debris will be removed from the kitchen floor and window sills.
4. Floors and walls will be cleaned and wiped down in order to remove debris prior to licensing.
5. Off-limits areas of the home will be made inaccessible.
6. All hazards from the kitchen such as raised linoleum will be removed or repaired.
7. Items such as make-up, curling irons, hair products, razors located in the children's bathroom will be made inaccessible.
8. Debris and hazards such as exposed fence nails, loose boards, tools, and tripping hazards will be removed from outdoor play areas and planter boxes or made inaccessible.
9. Both sheds located on the property shall remain locked or inaccessible during daycare hours.
10. Air conditioning unit's metal screen must be fully in tact and not loose from the unit.
11. Postings must be visible for parents to see upon exit and entry of the home.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra HusbandTELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020
LIC809 (FAS) - (06/04)
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