103900383-10-8-2024-04-CC-XXAG-D9UNYV-20241008105321

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 103900383
Report Date: 10/08/2024
Date Signed: 10/08/2024 10:53:36 AM

Document Has Been Signed on 10/08/2024 10:53 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME:	KINGSBY, ROCHELLE		FACILITY NUMBER:	103900383
ADMINISTRATOR:	KINGSBY, ROCHELLE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 264-7212
CITY:	FRESNO	STATE: CA	ZIP CODE:	93706
CAPACITY:	14	CENSUS: 3	DATE:	10/08/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Rochelle Kingsby		TIME COMPLETED:	11:15 AM

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On 10/08/2024 Licensing Program Analyst (LPA), Xona Xayavong and Licensing Program Manager, Kari McWilliams conducted an unannounced Annual Random Inspection and was met by licensee Rochelle Kingsby. Days and hours of operation are Monday through Friday from 7:00 am to 4:00 pm & 5:30 pm to 5:30 am.

LPA toured the home inside and outside and a census was taken. LPA reviewed current facility sketch and confirmed that the living room, kitchen, den, room 1, room 2, hallway bathroom, and backyard are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of doorknob spinners.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. All poisons are kept in a locked storage area. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

There is a fireplace heater located in the living room and it will not be utilized during day care hours. There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort.

This is a single level home and there are no stairs. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (559) 264-7212.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was completed on 12/13/2022. Licensee’s pediatric CPR/First Aid certification expires on 3/2026. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis, and measles.

Continue on 809-C

SUPERVISOR'S NAME: Kari McWilliams	TELEPHONE: (559)341-5422
LICENSING EVALUATOR NAME: Xona Xayavong	TELEPHONE: (559) 320-9885
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KINGSBY, ROCHELLE	FACILITY NUMBER: 103900383
	VISIT DATE: 10/08/2024

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LPA discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to resources such as forms, regulations Provider Information Notices (PINs), and Quarterly Updates. LPA discussed Reporting Requirements as outlined in the regulations (Section 102416.2).

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

There are currently no infants currently enrolled in care. LPA discussed safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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SUPERVISOR'S NAME: Kari McWilliams	TELEPHONE: (559)341-5422
LICENSING EVALUATOR NAME: Xona Xayavong	TELEPHONE: (559) 320-9885
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: KINGSBY, ROCHELLE	FACILITY NUMBER: 103900383
	VISIT DATE: 10/08/2024

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Exit interview conducted and report was reviewed with licensee Rochelle Kingsby. During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA verified the RSO profile in FAS.

Per Title 22, Division 12, Chapter 3 of the California Code of Regulations, no deficiencies are cited. Licensee was provided appeal rights.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

SUPERVISOR'S NAME: Kari McWilliams	TELEPHONE: (559)341-5422
LICENSING EVALUATOR NAME: Xona Xayavong	TELEPHONE: (559) 320-9885
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024

LIC809 (FAS) - (06/04)

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