045407823-12-15-2020-13-CC-SHUD-BWBMUR-20201215085531

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 045407823
Report Date: 12/14/2020
Date Signed: 12/15/2020 08:55:43 AM

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:	KINSER, FAMILY CHILD CARE HOME		FACILITY NUMBER:	045407823
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	12/14/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Stacy and Tony Kinser		TIME COMPLETED:	04:40 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	The facility pre-licensing inspection was conducted on 12/14/20 at 3:00 PM via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak by Licensing Program Analyst, LPA Sandy Husband. An application was received on 10/1/20 requesting a license for a capacity of 8. Operating hours will be available 7:00 am - 5:30 PM, Monday through Friday. The residence is a single story 4 bedroom/2 bath home. There are two adults living in the home. The applicant was advised that all adults 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. Children will have access to the living room, family room, kitchen, bathroom, dining room and laundry room. The off limit areas of the home include the four bedrooms, office, master bathroom and shed located in the backyard. These areas are made inaccessible via locks and a gate. The poisons/chemicals are stored in the shed and the upper cabinets in the laundry room. The applicant understands that poisons shall be kept locked. The home appears clean and orderly at this time and will remain so during childcare hours. There is a working telephone. The sharp knives, cleaning supplies, medicines, will be stored out of the reach of children. The firearms and ammunition are locked separately. 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 and a charged fire extinguisher that was rated at least 2A10BC. The applicant stated children will use the backyard as an outdoor play area and it is fully fenced. Currently, there are no bodies of water located on the premises, but there will be a seasonal above ground pool which is fully fenced with at least 5-foot wrought iron and chain link fencing with a self-closing, self-latching gate. 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. (Continued on LIC 809-C)

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra Husband	TELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2020

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: KINSER, FAMILY CHILD CARE HOME	FACILITY NUMBER: 045407823
	VISIT DATE: 12/14/2020

NARRATIVE

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(Continued from LIC 89)
Parents will be required to sign insurance affidavits if the provider does not plan to purchase additional childcare liability insurance. Control of Property is on file. Parent's rights poster was 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 which expires on 8/8/22 and Mandated Reporter Training which expires on 9/19/22. 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. 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 one of the children in care must be school aged and one at least 6 years of age. Smoking is prohibited at all times in those areas where childcare is provided. The applicant understands that the use of baby walkers, bouncers, inclined sleepers or similar items are not approved equipment for use in licensed childcare homes.

The applicant understands the responsibility to read and have knowledge of the laws and regulations for operation of a family childcare 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 advanced notice. This report was reviewed and discussed with the applicant. Guide to Safe Sleeping Practices pamphlet was discussed along with the Provider Notice and Flyer for Lead Exposure Testing.

Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

The following items are to be completed prior to licensure:
1. Knives shall be made inaccessible
2. Gas stove knobs shall be made inaccessible.

SUPERVISOR'S NAME: Megan Aviles	TELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Sandra Husband	TELEPHONE: 530-895-5822
LICENSING EVALUATOR SIGNATURE:	DATE: 12/14/2020

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2020

LIC809 (FAS) - (06/04)

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