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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 115407149
Report Date: 09/17/2019
Date Signed: 09/17/2019 03:28:54 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:YOUNG, KAREN FAMILY CHILD CARE HOMEFACILITY NUMBER:
115407149
ADMINISTRATOR:YOUNG, KARENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 865-7590
CITY:ORLANDSTATE: CAZIP CODE:
95963
CAPACITY:14CENSUS: 8DATE:
09/17/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Karen YoungTIME COMPLETED:
03:35 PM
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On 09/17/2019 an Annual/Random inspection was made to the facility by Licensing Program Analyst (LPA), David Wilson. Prior to this inspection and this date a review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. During today’s inspection the home and grounds were toured. The licensee and assistant were supervising eight children, and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. Operating hours are normally 7am to 5pm, Mon–Fri. The floor plan was verified. The off-limits areas (master bedroom and the door from house into and including garage) were inaccessible via child proof door knobs covers. The outdoor shed is off limits and kept locked (poisons are stored inaccessible/locked in this outdoor shed). The home is clean, orderly and comfortable. There are safe toys and equipment available for children. There is a working telephone in the home. The licensee and assistant have current pediatric CPR and First Aid certification, which expire on 03/02/2021. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) are stored out of the reach of children. There is a working smoke detector, carbon monoxide detector and charged fire extinguisher, rated at least 2A10BC, in the home. Firearms and ammunition are separately stored locked/inaccessible in a safe. The children use the backyard as the outdoor play area and it is fully fenced. There were no bodies of water observed. Seven children's records were reviewed; required emergency information was on file. The licensee is not providing Incidental Medical Services – IMS. Incidental Medical Services (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 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,www.ada.gov/childqanda.htm. This report, as well as the American Academy of Pediatrics Guide to Safe Sleep Practices brochure, were reviewed and discussed with the licensee. All licensing reports are public information and must be made available upon request for at least three years. Notice of Site Visit shall be posted for 30 days from today's visit. There were no Title 22 deficiencies cited during today's inspection.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David WilsonTELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2019
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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