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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153903787
Report Date: 10/22/2019
Date Signed: 10/30/2019 12:47:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:TRUSTY, STACI FAMILY CHILD CAREFACILITY NUMBER:
153903787
ADMINISTRATOR:TRUSTY, STACIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 589-0602
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:14CENSUS: DATE:
10/22/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Staci Trusty - Licensee TIME COMPLETED:
04:10 PM
NARRATIVE
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An unannounced Annual/Random Inspection was conducted today by Licensing Program Analyst (LPA) Jessika Thompson. LPA met initially met with licensee’s assistant, Mark Pieri, who was providing care to seven children. A tour of the facility was made. The licensee, Staci Trusty, arrived roughly 30 minutes into today’s inspection. Background clearances were discussed, and licensee signed LIS531 indicating all adults residing and/or providing care and supervision have a criminal record clearance. Licensee has current pediatric CPR and First Aid that expire on 02/16/21; however, Mr. Pieri's CPR card was expired. Accessible areas of the home are the living room, dining room, kitchen and hallway bathroom. Off-limit rooms are made inaccessible by spinning door knob covers, which were observed by LPA on this date. The home is clean and orderly, with heating and ventilation for safety and comfort. There are no stairs in the home. Safe, healthful, and comfortable accommodations, furnishings, toys and equipment were observed. There is a working telephone. Licensee has two cats that are accessible to children, and one large dog that is inaccessible to children. Licensee accepts full liability for any action taken by family pets. A current roster of children in care is maintained. LPA verified that immunization records are maintained, and licensee updates records for children in care. Licensee provides a copy of Parent’s Rights to all parents and/or child’s representative. Licensee ensures that children in care are supervised at all times. Fire and disaster drills are conducted at least once every six months, and documented with the date and time. There is a pool that fenced in accordance with Title 22 regulations. There are no firearms or weapons on the premises. Detergents, cleaning compounds, medications, and other items which could pose a danger to children are stored where they are inaccessible to children. Facility has required fire extinguisher and smoke detector, both meet State Fire Marshall standards. Facility has one functioning carbon monoxide detector that meets statutory requirements. Licensee understands children may not be left in parked vehicles. The practice of safe sleep for infants in family child care homes was discussed and reviewed. Lead safety was discussed, and LPA provided Licensee with a brochure. Licensee understands that lead safety information must also be provided to parents and/or authorized representatives of children in care. Provider Information Notices were discussed, and licensee is signed up to receive updates via email(Continued on LIC809-C).
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME: TRUSTY, STACI FAMILY CHILD CARE
FACILITY NUMBER: 153903787
VISIT DATE: 10/22/2019
NARRATIVE
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Licensee is aware that forms and updated information may be obtained on the Community Care Licensing Division's website: (www.ccld.ca.gov). Licensee and assistant have proof of Child Abuse Mandated Reporter training, both completed 01/30/19 . Licensee was advised that this certification must be renewed every two years. Licensee understands that it is her responsibility to stay current with regulations. Licensee is urged to visit the U.S. Consumer Product Safety Commission web page at www.cpsc.gov to ensure that equipment purchased for the day care have not been recalled.

Incidental Medical Services (IMS) are not currently being provided. Licensee was advised that if/when any IMS is provided, a Plan for Providing IMS must be submitted to the Department.

Licensee was advised that the Duty Officer is available to answer questions Monday – Friday at 1-844-LET-US-NO (1-844-538-8766).

Hours of operation are Monday through Friday, from 7:00 AM to 6:00 PM, and as arranged; less than 24 hours. Licensee is reminded of inspection authority by employees of the Department at any time, with or without advance notice.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, the following deficiencies are found: (see LIC809-D)

In exit interview the licensee was advised of appeals rights and was provided with Appeals Rights. Licensee was also advised that this report with Type A Deficiencies must be posted for 30 days where parents may easily view and filed in facility file for public review for 3 years.

Licensee is advised to make this licensing report accessible to the public and to provide copies of this licensing report and 809D with Type A citation to parents/legal guardians of children in care and to parents/legal guardians of children newly enrolled at the facility during the next 12 months. Licensee is to keep verification of receipt (LIC9224) in each child's file at the facility. An LIC9224 and Assembly Bill 633 fact sheet was provided to licensee on this date.

LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS

SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:

DATE: 10/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: TRUSTY, STACI FAMILY CHILD CARE
FACILITY NUMBER: 153903787
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/29/2019
Section Cited

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(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
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This requirement was not met, as evidenced by LPA's observations. Today, upon arrival, LPA observed the licensee's assistant, Mark Pieri, solely caring for seven children. Of the children present, none were enrolled in and attending kindergarten, or at least six years of age, as required. This poses an immediate risk to the health, safety or personal rights of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 10/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: TRUSTY, STACI FAMILY CHILD CARE
FACILITY NUMBER: 153903787
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/22/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/22/2019
Section Cited

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Personnel Requirements. The Licensee and other personnel as specified shall complete training on preventive health practices including pediatric cardiopulmonary resuscitation and pediatric first aid,
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 pursuant to Health and Safety Code Section 1596.866. This requirement was not met, as evidenced by LPAs observations and records review. Today, upon arrival, LPA found the licensee's assistant, Mark Pieri, solely providing care to seven children. During records review, LPA confirmed that Mr. Pieri's CPR card expired in September of 2019. This poses a potential risk to the health, safety or personal rights of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Diana deLeonTELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Jessika ThompsonTELEPHONE: 559-341-4622
LICENSING EVALUATOR SIGNATURE:
DATE: 10/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4