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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 153910238
Report Date: 09/03/2019
Date Signed: 09/03/2019 12:23:37 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:HARRIS, JENNIFER FAMILY CHILD CAREFACILITY NUMBER:
153910238
ADMINISTRATOR:HARRIS, JENNIFERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(661) 589-8825
CITY:BAKERSFIELDSTATE: CAZIP CODE:
93312
CAPACITY:14CENSUS: 12DATE:
09/03/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jennifer Harris- Licensee TIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Jessika Thompson conducted an unannounced annual/random inspection. LPA met with Jennifer Harris. Also present were licensee's assistants Sharaea Williams and Michaela Burke. A tour of the home, as shown on the facility sketch, was made. There are no fire arms or weapons on the premises. Off limits areas are made inaccessible by use of spinning door knob covers and baby gates. Required forms are posted. Stairs are barricaded. Smoke and carbon monoxide detectors meet State Fire Marshall standards. The home is kept clean and orderly, with heating and ventilation for safety and comfort. Safe toys and play equipment were observed. There is a working telephone. Adequate supervision was provided during this visit. Outdoor play areas are fenced and supervised by the licensee or care giver. Licensee has two dogs, one mini pigs and ten chickens, four ducks, that are inaccessible to children. Licensee accepts full liability for any action taken by family pets. Capacity as specified on the license is being maintained. Staff-child ratios are maintained. Children’s records contain all emergency information specified by regulation. There are no excluded individuals present at this home. All adults who reside or work in the home have a criminal record clearance or exemption as indicated on Facility Roster. Licensee has current pediatric CPR and First Aid that expires on 08/08/2021. Licensee has proof of Child Abuse Mandated Reporter training, completed 02/2018. Licensee is aware of safe sleep concepts for infants in care. Licensee maintains proof of immunization, for herself and assistants, within the family child care home. 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 aware that forms and updated information may be obtained on the Community Care Licensing Division website (www.ccld.ca.gov). Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. Licensee reported that currently she does not have any children enrolled requiring IMS. Licensee was advised that if/when any IMS is provided, a Plan for Providing IMS must be submitted to the Department. Business hours are Monday - Friday, 6:30 AM - 4:30 PM and as arranged.

Per Chapter 3, Division 12, Title 22 of the California Code of Regulations, no deficiencies were observed today.

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: 09/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2019
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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