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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 125407783
Report Date: 08/16/2021
Date Signed: 08/16/2021 12:26:12 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:HARRIS, GINA FAMILY CHILD CARE HOMEFACILITY NUMBER:
125407783
ADMINISTRATOR:HARRIS, GINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 599-5714
CITY:EUREKASTATE: CAZIP CODE:
95503
CAPACITY:14CENSUS: 10DATE:
08/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Gina HarrisTIME COMPLETED:
12:45 PM
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An annual inspection was made to the facility by Licensing Program Analyst (LPA) Kiriko Lynch. A review of staff records on 08/16/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances and/or exemptions through the Department. During today’s inspection the home and grounds were toured. The Licensee and assistant were supervising 10 children, and operating within the licensed capacity and ratio requirements. The facility’s current operating days and hours are 7:30 a.m. to 5:30 p.m., Monday–Friday. The floor plan submitted by the Licensee was reviewed and verified. The off-limits areas of the home are currently: entire upstairs, downstairs bedroom, office, half bathroom, fenced front and side yard, detached garage, and are made inaccessible by gates, fencing, and/or child-safety knobs/latches/locked doors. The home is clean, orderly and comfortable, with heating and ventilation for safety and comfort. There are safe toys and equipment available for children. There is a working telephone in the home. No infants were observed to be swaddled or sleeping in car seats. Safe sleep logs were observed in children's files as needed. Items which could pose a danger to children (detergents, cleaning compounds, medications, hazards, etc.) are stored in inaccessible areas out of reach of children. Wood fireplace is barricaded by a screen, and not used during childcare hours. Home utilizes forced air. Stairs are barricaded with a gate at the lower level. Backyard play area is fenced, and hot tub is inaccessible, unused, and locked/barricaded by six foot fence in off-limits fenced front yard area. Licensee stated she provides 100 percent supervision in all unfenced areas. There is a working smoke detector, carbon monoxide detector and fire extinguisher, rated at least 2A10BC, in the home. The Licensee has current pediatric CPR and First Aid certification, and it expires on 06/30/22. Three children's records were reviewed at 12:00 p.m., and required emergency information was observed to be on file. This report, as well as the Safe Sleep regulations, ongoing renewal of every two years mandated reporter training, and CDPH lead flyer requirement 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. The facility is in substantial compliance during today's visit. No Title 22 deficiencies were cited during today's inspection. An Exit Interview was conducted, and a Notice of Site Visit was provided to the Licensee, and posted at the time of visit.
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Kiriko LynchTELEPHONE: (530) 895-5033
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021
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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