283010007-6-23-2021-01-CC-KOCL-C49V3Q-20210623160504

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 283010007
Report Date: 06/23/2021
Date Signed: 06/23/2021 04:05:10 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 FCCH		FACILITY NUMBER:	283010007
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	06/23/2021
TYPE OF VISIT:	Post Licensing	UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:	Kailey McGuire, Licensee		TIME COMPLETED:	02:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	A Post Licensing inspection was made to the facility by Licensing Program Analyst (LPA) Kevin O'Connell. A review of staff records on 06/23/21 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. There are currently two adults living in the home. During today’s inspection the home and grounds were toured. The licensee was supervising four children, and operating within the licensed capacity and ratio requirements. No children were observed left in any parked vehicle. The facility’s operating hours are 08:00AM to 05:00PM, Monday–Thursday. The off-limits areas of the home are owners bedroom #3 & bathroom, family room, laundry room and garage. They were made inaccessible by means of door handle covers and baby gates. The home was clean and orderly, and was at a comfortable indoor temperature. There were safe toys and equipment available for children. There is a working telephone in the home. The licensee has current pediatric CPR and First Aid certifications, which expire on 01/2023. Items which could pose a danger to children (detergents, cleaning compounds, medications, etc.) were stored out of the reach of children. Licensee states that there are no poisons but can lock them in a cabinet in the "off limits" garage. The fireplace is electric, unplugged and not used and is in the "off limits" family room and has a glass face. There is a working smoke detector, carbon monoxide detector and a 2A10BC charged fire extinguisher. The Licensee states that there are no firearms or dangerous weapons and none were observed. The back yard is currently "off limits" and a nearby park is used for outdoor play. One staff file was reviewed at 01:00pm and contained Mandated Reporter Certificates and immunizations.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021

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 2

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: 06/23/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The Licensee stated that there are no water features and none were observed. Four children's records were reviewed at 01:10PM; required emergency information was observed to be on file.
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 was 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.

No Title 22 violations were cited during today's inspection.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Kevin O'Connell	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2