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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283010007
Report Date: 02/24/2021
Date Signed: 02/24/2021 01:57:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME:MCGUIRE, KAILEY FCCHFACILITY NUMBER:
283010007
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
02/24/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Kailey McGuire, LicenseeTIME COMPLETED:
12:00 PM
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Due to Covid-19 this tele-visit was conducted with Zoom and Facetime. An announced tele-visit was made to the facility by LPA, Kevin O'Connell. A review of the personnel report on file indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.
The applicant is requesting a license for a capacity of 8 children. The applicant understands that 24 hr consecutive care is prohibited. The residence is a four bedroom/ two bathroom single family home.
There are presently two adults living in the home. The applicant was advised that all adults residing or working at the facility must have a criminal background clearance on file with CCLD. The applicant is aware of the immediate $100 per day civil penalty for adults working or residing in the home without a criminal record clearance.
The floor and yard plans are verified. The children will have access to the front living room, dining room, kitchen, bedrooms 1, 2, & 3, & the hall bathroom. Off limits areas are the laundry room, garage, living room #2, Main bedroom and bathroom. The backyard is off limits. The nearby park will be used for outdoor play.
The home appears to be clean and orderly at this time and will remain so during child care hours. There is a working telephone in the home. The sharp knives, cleaning supplies, medicines, are stored out of the reach of children. The applicant states that there are no guns or dangerous weapons in the home. First Aid supplies will be maintained at the facility and are inaccessible to children. The children in care will have access to age appropriate toys and equipment. The home is equipped with a working smoke detector, carbon monoxide detector and has a fire extinguisher rated 2A 10:BC. There is no spa, pool, pond, fountain or other body of water on the premises. None shall be added without prior approval from the Licensing agency.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: MCGUIRE, KAILEY FCCH
FACILITY NUMBER: 283010007
VISIT DATE: 02/24/2021
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Parents will be required to sign insurance affidavits if the provider does not plan to purchase additional child care liability insurance. Parent's rights poster is posted. Emergency drills must be conducted at least once every six months and the date documented. Children's records to be maintained were provided. The roster is to remain current at all times. The licensee will maintain current pediatric CPR and First Aid certifications. The licensee shall be present in the home and shall ensure that children in care are supervised by a fingerprinted adult with current pediatric CPR and First Aid certification. The applicant understands that children may only be transported by adults with a criminal record clearance and are never to be left unattended in a vehicle. Infants and children shall not be allowed to sleep in car carriers in the home. The applicant clearly understands the maximum number of children for whom care can be provided and the limitations on the number of infants (birth to age 2) that may be cared for and when two of the children in care must be school aged. Smoking is prohibited at all times in any area where child care is provided. The licensee understands the responsibility to read and have knowledge of the laws and regulations for operation of a family child care home. Forms and regulations must be obtained from the website. http://ccld.ca.gov/. Megan's Law web site is provided (http://www.meganslaw.ca.gov). The AAP Guide to Safe Sleep Practices and the Effects of Lead Exposure brochures were provided. The applicant understands that any authorized employee of the Department may enter and inspect the facility with or without advance notice. A Covid-19 Zoom Technical Assistance meeting was conducted 2/24/2021.
Any proposed changes to the physical plant, telephone number, or change of address shall be immediately reported to the Department.

License is granted as of today, 2/24/21.
SUPERVISOR'S NAME: Leslie LeporiTELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'ConnellTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2021
LIC809 (FAS) - (06/04)
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